Diagnostic workup in incontinent patients: An integrated approach

Carlo Ratto, Angelo Parello, Lorenza Donisi, Francesco Litta, Giovanni B. Doglietto, Scott R. Steele, Ann C Lowry, Anders F. Mellgren

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Anal continence is assured by the activity of complex anatomical and physiological structures (anal sphincters, pelvic floor musculature, rectal curvatures, transverse rectal folds, rectal reservoir, rectal sensation). It is dependent also on numerous other factors, such as stool consistency, patient's mental faculties and mobility, and social convenience. Only if there is an effective, coordinated integration between these elements can defecation proceed normally. On the other hand, fecal incontinence (FI) is the result of disruption of one or several of these different entities: frequently, it can be due to a multifactorial pathogenesis, and in many cases, it is not secondary to sphincter tears. The disruption could lie in alterations intrinsic to the anorectal neuromuscular structures of continence control or be extrinsic to them, involving extrapelvic control mechanisms. The primary aim of an effective therapeutic approach must be the improvement-better, the resolution-of this distressing condition. Different forms of therapy are now available so that physicians must select the best option for each patient.

Original languageEnglish (US)
Title of host publicationFecal Incontinence
Subtitle of host publicationDiagnosis and Treatment
PublisherSpringer Milan
Pages135-147
Number of pages13
ISBN (Print)9788847006379
DOIs
StatePublished - Dec 1 2007

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