Function and dysfunction of the colon and anorectum in adults: Working team report of the Swedish Motility Group (SMoG)
(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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1425517
- author
- organization
- publishing date
- 2009
- type
- 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
- pmid:19191186
- 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
- 2016-04-01 13:21:46
- date last changed
- 2022-01-27 18:46:31
@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}},
keywords = {{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}},
doi = {{10.1080/00365520902718713}},
volume = {{44}},
year = {{2009}},
}