Abstract:
Fecal incontinence is the involuntary passage or the incapacity to control the release of fecal matter through the anus. It is a condition that significantly impairs quality of life in those that suffer from it, given that it affects body image, self-esteem, and interferes with everyday activities, in turn, favoring social isolation. There are no guidelines or consensus in Mexico on the topic, and so the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, neurogastroenterologists, and surgeons) to carry out the «Mexican consensus on fecal incontinence» and establish useful recommendations for the medical community. The present document presents the formulated recommendations in 35 statements. Fecal incontinence is known to be a frequent entity whose incidence increases as individuals age, but one that is under-recognized. The pathophysiology of incontinence is complex and multifactorial, and in most cases, there is more than one associated risk factor. Even though there is no diagnostic gold standard, the combination of tests that evaluate structure (endoanal ultrasound) and function (anorectal manometry) should be recommended in all cases. Treatment should also be multidisciplinary and general measures and drugs (lidamidine, loperamide) are recommended, as well as non-pharmacologic interventions, such as biofeedback therapy, in selected cases. Likewise, surgical treatment should be offered to selected patients and performed by experts.
摘要:
大便失禁是无意识的通道或不能控制粪便物质通过肛门的释放。这是一种严重损害患有这种疾病的人生活质量的疾病,考虑到它影响身体形象,自尊,干扰日常活动,反过来,有利于社会隔离。墨西哥没有关于这个主题的指导方针或共识,因此,墨西哥胃肠病协会汇集了一个多学科小组(胃肠病学家,神经胃肠病学家,和外科医生)进行“墨西哥关于大便失禁的共识”,并为医学界建立有用的建议。本文件在35份声明中提出了拟定的建议。众所周知,大便失禁是一种常见的实体,其发病率随着个体年龄的增长而增加。但认识不足。失禁的病理生理学是复杂和多因素的,在大多数情况下,相关风险因素不止一个。即使没有诊断金标准,在所有情况下,应建议结合评估结构(肛门内超声)和功能(肛门直肠测压)的测试。治疗也应该是多学科和一般的措施和药物(利达米定,洛哌丁胺)推荐,以及非药物干预,比如生物反馈治疗,在选定的情况下。同样,应向选定的患者提供手术治疗,并由专家进行。