Causes of fecal incontinence
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All psychoneurological disorders can cause constipation and thus fecal overflow incontinence for rectal impaction.
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Neurological disorders affecting at or below the sacral parasympathetic outflow, extrinsic and intrinsic innervation of the recto-ano-pelvic area.
Diagnosis of fecal incontinence
In all patients
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Exclude structural recto-ano-pelvic alterations and fecal impaction.
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Evaluate the presence of liquid stools.
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Anorectal Manometry
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Neurophysiologic investigations of the pelvic floor
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In specific patients
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Autonomic tests
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Psychiatric assessment
Management of fecal incontinence
Fecal impaction (see constipation)
Liquid stools (see diarrhea)
Recto-Ano-Pelvic dysfunction with only partial or no denervation
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*Toilet training
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*Manometry-controlled biofeedback
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*Physiotherapy
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*Electrostimulation
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*Loperamide
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Recto-Ano-Pelvic dysfunction with total denervation
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*Trigger defecatory reflex with physical maneuvers + glycerin, stimulant laxative suppository *Electrostimulation of S2-S3 roots.
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*Malone anterograde enema
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*Colostomy
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