P. F. Vollebregt

Impacts of perianal disease and faecal incontinence on quality of life and employment in 1092 patients with inflammatory bowel disease

Patient reported outcomes regarding perianal disease and faecal incontinence in the community‐based inflammatory bowel disease population are poorly described.

Validation of Risk Factors for Fecal Incontinence in Patients With Crohn’s Disease

BACKGROUND: Fecal incontinence has a great impact on daily life, and many patients are reluctant to report it. OBJECTIVE: The purpose of this study was to estimate the prevalence of fecal incontinence in patients with Crohn’s disease, validate risk factors, and relate outcome with quality of life. DESIGN: The design was cross-sectional. SETTINGS: The study was conducted at an academic tertiary center. PATIENTS: Consecutive patients with Crohn’s disease treated between 2003 and 2013 were included in this study. MAIN OUTCOME MEASURES: A questionnaire was sent out in October 2013 to evaluate perianal disease, current symptoms of fecal incontinence, and its impact on quality of life (Fecal Incontinence Quality of Life questionnaire). Risk factors were validated with univariate and multivariate analyses. RESULTS: The questionnaire was responded by 325 (62%) of 528 patients. Median age was 42 years (range, 18–91 y), 215 (66%) were women, and a diagnosis of Crohn’s disease was established for a median period of 12 years (interquartile range, 6–21 y). Fecal incontinence was reported by 65 patients (20%). Fecal incontinence was associated with liquid stools (p = 0.0001), previous IBD-related bowel resections (p = 0.001), stricturing behavior of disease (p = 0.02), and perianal disease (p = 0.03). Quality of life (lifestyle, coping, depression, and embarrassment) was poor in patients with fecal incontinence, particularly in patients with more frequent episodes of incontinence. LIMITATIONS: There was no correction for disease activity in the multivariate regression analysis. CONCLUSIONS: The prevalence of fecal incontinence in a tertiary population with Crohn’s disease is substantially higher than in the community-dwelling population. Considering the reduced quality of life in incontinent patients, active questioning to identify fecal incontinence is recommended in those with liquid stools, perianal disease, or previous (intestinal or perianal) surgery. See Video Abstract at http://journals.lww.com/dcrjournal/Pages/videogallery.aspx.

Surgery for constipation : systematic review and practice recommendations : Results III: Rectal wall excisional procedures (Rectal Excision)

To assess the outcomes of rectal excisional procedures in adults with chronic constipation.

Surgery for constipation: systematic review and clinical guidance: Paper 1: Introduction & Methods.

This manuscript provides the introduction and detailed methodology used in subsequent reviews to assess the outcomes of surgical interventions with the primary intent of treating chronic constipation in adults and to develop recommendations for practice.

Surgery for constipation: systematic review and practice recommendations: Graded practice and future research recommendations.

This manuscript forms the final of seven that address the surgical management of chronic constipation (CC) in adults. The content coalesces results from the five systematic reviews that precede it and of the European Consensus process to derive graded practice recommendations (GPR).

Continence technologies whitepaper: Informing new engineering science research:

Advances in healthcare technology for continence have historically been limited compared to other areas of medicine, reflecting the complexities of the condition and social stigma which act as a barrier to participation. This whitepaper has been developed to inspire and direct the engineering science community towards research opportunities that exist for continence technologies that address unmet needs in diagnosis, treatment and long-term management. Our aim is to pinpoint key challenges and highlight related research opportunities for novel technological advances. To do so, we draw on experience and expertise from academics, clinicians, patients and patient groups linked to continence healthcare. This is presented in four areas of consideration: the clinical pathway, patient perspective, research challenges and effective innovation. In each we introduce seminal research, background information and demonstrative case-studies, before discussing their relevance to engineering science researchers who are interested in approaching this overlooked but vital area of healthcare.

Editorial: faecal incontinence-the hidden burden of inflammatory bowel diseases. Authors' reply

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