GASTROENTEROLOGY ARTICLE OF THE WEEK
August 23, 2007
Rao SS. Fecal incontinence in a 56 year old female executive. Clin Gastroenterol Hepatol 2007;5:422-26.
True or False
1. Urge incontinence is usually caused by decreased rectal sensation
2. Involuntary discharge of stool without awareness usually suggests a neuropathy or impaired rectal sensation
3. Surgical correction of sphincter disruption due to childbirth brings improvement in 70% of cases, but long-term success is only about 30%
4. Seepage of very small amount of stool matter without awareness usually reflects dyssynergia of the pelvic floor and anal sphincter
5. MRI is superior to anal ultrasound for the structural evaluation of the external anal sphincter and should be obtained in all patients with incontinence
6. Loperamide is most helpful in patients with diarrhea and/or urge-related fecal incontinence.
7. Anal plugs are a new innovative, space-age solution to incontinence that is not well tolerated by patients
8. Injecting collagen in the anus instead of the lips (also known as the RAJ look or Reverse Angelina Jolie look) may result in less incontinence.
9. Defecography is most useful in the evaluation of patients with urge incontinence