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Fecal pattern and symptoms of disordered anorectal function in inflammatory bowel diseases.

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eMediNexus    06 July 2018

A new article published in Advances in Clinical and Experimental Medicine assessed stool patterns and the prevalence of symptoms of disordered anorectal function, specifically urgency and fecal incontinence, and their severity in patients with inflammatory bowel diseases (IBDs). The study enrolled 33 patients with Crohns disease (CD) and 38 patients with ulcerative colitis (UC) who completed a questionnaire. A push/strain maneuver was performed on all patients and 20 controls. The results showed that all the patients had more than 3 bowel movements a day; among these 44 had loose/watery stools. While two patients had less than 3 bowel movements a week; 8 had hard/lumpy stools; and 3 used laxatives. Meanwhile, excessive straining and incomplete evacuation were reported by 17 and 38 patients, respectively. On the other hand, 52 patients complained of urgency and 32 of tenesmus. The number of UC patients who experienced urgency at least once a day was notably higher when compared to CD patients. The following symptoms were reported by patients in the following numbers: fecal incontinence (31), passive (20) and urge incontinence (16), incontinence to gas (24), as well as liquid (33), and solid stool (7). Stool/gas discrimination was defective in 28 patients. Eleven patients had to wear pads. Everyday functioning was worsened because of urgency/tenesmus in 39 patients and because of fecal incontinence in 28 patients. Furthermore, the push/strain maneuver was abnormal in 12 patients with CD, 15 patients with UC, and 1 control subject. The differences between the two study groups and the controls were significant. Hence, it was concluded that a majority of patients with IBD complain of urgency while fecal incontinence is reported by over 50% of patients. Both worsen patients quality of life. It was further stated that a relevant proportion of patients have symptoms consistent with constipation, which is in linked to an abnormal push/strain maneuver in more than 1/3 of them.

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