PMID: 9193928Jun 1, 1997Paper

Manometric evaluation of defecation disorders: Part II. Fecal incontinence

The Gastroenterologist
S S Rao

Abstract

Fecal incontinence is a silent affliction that often leads to self-imposed ostracism. For many years, a lack of understanding regarding its pathophysiology and a lack of empathy among many physicians has bedeviled this problem. However, during the last two decades, remarkable strides have been made, both in the evaluation and in the treatment of incontinence. These advances stem from the ability to perform a detailed and comprehensive assessment of anorectal physiology. Anorectal manometry has spearheaded this renaissance. Manometry is not a single test but consists of a series of measurements that include an assessment of anal sphincter function, rectal sensation, rectoanal reflexes, and rectal compliance. Electrophysiological assessments such as pudendal nerve terminal latency can provide additional information regarding neuromuscular integrity. Newer techniques such as vectography, saline continence test, impedance planimetry, and prolonged ambulatory anorectal manometry have added a new dimension to the overall assessment. Radiological tests such as defecography and anal endosonography can provide complimentary information. These tests of anorectal function have advanced immensely our understanding of the pathophysiological...Continue Reading

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