Causes and assessment of faecal incontinence

Faecal incontinence remains a taboo subject and patients frequently conceal their symptoms, because of fear and embarrassment. Sensitive and appropriate assessment will encourage people to seek advice and treatment if required. This article discusses the causes and assessment of faecal incontinence. It explains the structure and function of the anal sphincters in maintaining continence. Assessment of bowel control is discussed in depth. Questions are suggested which will help to identify problems and thereby enable access to appropriate care

A nursing assessment tool for adults with fecal incontinence.

Fecal incontinence affects slightly more than 1% of community-dwelling adults. This article describes an assessment format, with a research basis when available, that has been developed in a specialist nursing clinic in the United Kingdom. The focus is on how to obtain the most useful information from the patient to plan appropriate nursing interventions. A subsequent article will describe the biofeedback program developed as part of a package of care to meet individual needs of persons with fecal incontinence

Benefits of interprofessional education in health care.

This article examines some of the literature regarding the benefits of interprofessional education (IPE) in the field of health care. These benefits in relation to service users (and carers), higher education institutions, service providers and students are all explored. Barriers to IPE are being broken down by many of the various stakeholders working towards a similar agenda. However, currently there remains some doubt as to whether IPE has a direct positive impact on the health gain of service users and carers. Research is needed to demonstrate if service users and carers benefit directly from IPE and if they do not, the reason for pursuing it needs to be questioned

Using therapeutic groups to support women with faecal incontinence.

In this paper, the authors describe the use of facilitated patient groups, in the management of women with faecal incontinence (FI). Two types of groups are discussed--a psychoeducational group and a psychotherapy group. Detailed descriptions of some of the themes which emerged in these groups are provided. The effectiveness of such groups is described, with regard to both psychological and physical functioning. Further investigation into the use of groups for this patient population is recommended

Bowel problems and coping strategies in people with multiple sclerosis.

Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in the UK. Bowel symptoms are reported to be common in MS, with constipation affecting 29-43% and faecal incontinence affecting just over 50%. Both have an impact on quality of life. Very little is known about how people with MS manage their bowels and the effectiveness of different interventions. We conducted a 2-part survey of people with MS and bowel problems. MS Society members were invited to participate in an online survey: 155 replied. 47 people additionally filled in a more detailed postal questionnaire. In this self-selected sample, 34% spend more than 30 minutes a day managing their bowel. Managing bowel function was rated as having an impact equal to mobility difficulties on quality of life. Respondents used a wide range of strategies to manage their bowel but few were rated as very helpful. There is a need for high quality research on all aspects of managing bowel dysfunction in MS in order to improve patients' quality of life

Stigma, taboos, and altered bowel function

This article discusses the concepts of stigma and taboos and their relevance to bowel function and gastrointestinal disorders. The author debates the definitions regarding the concepts of stigma and taboos and considers the effects of stigma on the stigmatised and non-stigmatised person. The types of stigma experienced by individuals with chronic illness are examined and the effect of stigma in specific gastrointestinal disorders is reviewed. The interventions to try to reduce the stigma associated with bowel function and gastrointestinal disorder are also explored. It is hoped that this article will contribute to a debate on addressing the issue of stigma in the UK

Fecal incontinence: the quality of reported randomized, controlled trials in the last ten years.

This study was designed to analyze the characteristics and the quality of reporting of randomized, controlled trials published during the last ten years on fecal incontinence

Uncovering anorexia nervosa in a biofeedback clinic for bowel dysfunction

Biofeedback is a conservative treatment based on behavioural techniques, which can be used in the management of bowel dysfunction. This article reports the results of a retrospective review of the clinical notes of 87 female patients attending a biofeedback service at St Mark's Hospital, Harrow. The initial review was conducted to examine the incidence of polycystic ovary syndrome (PCOS) in patients attending this service. Seven percent were found to have PCOS, which is within the normal range. However, a significant proportion of patients (11.5%) had a current history of anorexia nervosa, a higher rate than in the general population, which prompted further investigation. In this article, Sonya Chelvanayagam, Julie Duncan, Brigitte Collins and Lorraine O'Brien report on the results of this review and discuss the significance of its findings. © Copyright Terms & conditions

Eating disorders: practical assessment and impact on the GI system

People experiencing eating disorders (such as anorexia nervosa, bulimia nervosa or binge eating) are regularly seen in gastrointestinal services. Eating disorders have direct effects on the gastrointestinal system causing symptoms such as severe constipation. A person with an eating disorder may be unaware of this disorder or deny its existence. Also, the symptoms of an eating disorder can conceal an underlying gastrointestinal disorder