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Function and dysfunction of the colon and anorectum in adults: Working team report of the Swedish Motility Group (SMoG)

Karling, Pontus; Abrahamsson, Hasse; Dolk, Anders; Hallbook, Olof; Hellstrom, Per M.; Knowles, Charles H.; Kjellstrom, Lars; Lindberg, Greger; Lindfors, Per-Johan and Nyhlin, Henry, et al. (2009) In Scandinavian Journal of Gastroenterology 44(6). p.646-660
Abstract
Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with... (More)
Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with severe slow-transit constipation and for those with large rectoceles that demonstrably cause rectal evacuatory impairment. For patients with fecal incontinence that does not resolve on antidiarrheal treatment, functional and structural evaluation with anorectal manometry and endoanal ultrasound or magnetic resonance (MR) of the anal canal may help to guide management. Sacral nerve stimulation is a rapidly evolving alternative when other treatments such as biofeedback and direct sphincter repair have failed. Advances in understanding the pathophysiology as a guide to treatment of patients with constipation and fecal incontinence is a continuing important goal for translational research. The content of this article is a summary of presentations given by the authors at the Fourth Meeting of the Swedish Motility Group, held in Gothenburg in April 2007. (Less)
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Contribution to journal
publication status
published
subject
keywords
gastrointestinal disorders, functional, fecal incontinence, Anal incontinence, constipation, gastrointestinal motility disorders
in
Scandinavian Journal of Gastroenterology
volume
44
issue
6
pages
646 - 660
publisher
Taylor & Francis
external identifiers
  • wos:000266199200001
  • scopus:67651159346
ISSN
1502-7708
DOI
10.1080/00365520902718713
language
English
LU publication?
yes
id
75b3d498-81f4-42f2-bdbf-c45a31347521 (old id 1425517)
date added to LUP
2009-07-01 15:38:53
date last changed
2017-01-01 05:37:39
@article{75b3d498-81f4-42f2-bdbf-c45a31347521,
  abstract     = {Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with severe slow-transit constipation and for those with large rectoceles that demonstrably cause rectal evacuatory impairment. For patients with fecal incontinence that does not resolve on antidiarrheal treatment, functional and structural evaluation with anorectal manometry and endoanal ultrasound or magnetic resonance (MR) of the anal canal may help to guide management. Sacral nerve stimulation is a rapidly evolving alternative when other treatments such as biofeedback and direct sphincter repair have failed. Advances in understanding the pathophysiology as a guide to treatment of patients with constipation and fecal incontinence is a continuing important goal for translational research. The content of this article is a summary of presentations given by the authors at the Fourth Meeting of the Swedish Motility Group, held in Gothenburg in April 2007.},
  author       = {Karling, Pontus and Abrahamsson, Hasse and Dolk, Anders and Hallbook, Olof and Hellstrom, Per M. and Knowles, Charles H. and Kjellstrom, Lars and Lindberg, Greger and Lindfors, Per-Johan and Nyhlin, Henry and Ohlsson, Bodil and Schmidt, Peter T. and Sjolund, Kristina and Sjovall, Henrik and Walter, Susanne},
  issn         = {1502-7708},
  keyword      = {gastrointestinal disorders,functional,fecal incontinence,Anal incontinence,constipation,gastrointestinal motility disorders},
  language     = {eng},
  number       = {6},
  pages        = {646--660},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Function and dysfunction of the colon and anorectum in adults: Working team report of the Swedish Motility Group (SMoG)},
  url          = {http://dx.doi.org/10.1080/00365520902718713},
  volume       = {44},
  year         = {2009},
}