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Bowel management is the process which a person with a bowel disability uses to manage fecal incontinence or constipation. [1] People who have a medical condition which impairs control of their defecation use bowel management techniques to choose a predictable time and place to evacuate. [ 1 ]
Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents — including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom, not a diagnosis.
The relative effectiveness of surgical options for treating fecal incontinence is not known. [2] A combination of different surgical and non-surgical therapies may be optimal. [ 2 ] A surgical treatment algorithm has been proposed for FI, [ 3 ] although this did not appear to include some surgical options.
A Cochrane review found evidence that transanal irrigation was more effective compared to conservative management in the management of spinal cord injury. There were more positive benefits for constipation scores, neurogenic bowel dysfunction scores, and fecal incontinence scores.
Compared to other surgical treatment options for fecal incontinence, implantable bulking agents appear to be safe. [6] Therefore, it is also suitable for elderly or frail patients. [6] However, complications are sometimes reported. For example, acute sepsis (infection) at the implantation site has been rarely recorded. [6]
Although only 20% decided to continue using the plug on a regular basis, anal plugs were generally successful at controlling fecal incontinence. Since anal plugs are considered an invasive strategy, they can result in pain, soreness, irritation, fecal urgency, and societal embarrassment. [2] Bleeding hemorrhoids were a rare adverse event. [13]
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