Fecal Incontinence: Nonsurgical Management

10.2310/obg.19158 ◽

2017 ◽

Author(s):

Madeleine Blank ◽

Lilian Chen

Keyword(s):

Quality Of Life ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Nonoperative Management ◽

Disease Process ◽

The United States ◽

Pelvic Floor Physical Therapy ◽

Nonsurgical Management ◽

Accidental Bowel Leakage

Fecal incontinence is the uncontrolled passage of feces or flatus. It is a debilitating and often unrecognized condition whose prevalence is increasing with our aging population and often carries significant stigmata associated with decreased quality of life. It is also one of the leading causes of nursing home admissions in the United States. The etiology of fecal incontinence is multifactorial, with many risk factors contributing to this disease process. Treatment may be challenging and needs to be individualized. In this review, we discuss the initial evaluation of the patient presenting with fecal incontinence, adjunctive testing modalities, and nonoperative management. This review contains 6 figures, 2 tables and 50 references Key words: accidental bowel leakage, biofeedback, bowel incontinence, fecal incontinence, pelvic floor physical therapy, pelvic floor retraining

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Surgical versus Nonsurgical Management of Postmastectomy Lymphedema: A Prospective Quality of Life Investigation

Journal of Reconstructive Microsurgery ◽

10.1055/s-0040-1713667 ◽

2020 ◽

Vol 36 (08) ◽

pp. 606-615

Author(s):

Halley Darrach ◽

Pooja S. Yesantharao ◽

Sarah Persing ◽

George Kokosis ◽

Hannah M. Carl ◽

...

Keyword(s):

Quality Of Life ◽

Upper Extremity ◽

Nonoperative Management ◽

Multivariable Analysis ◽

Sociodemographic Factors ◽

Surgical Patients ◽

Linear Modeling ◽

Secondary Lymphedema ◽

Nonsurgical Management

Abstract Background Postmastectomy secondary lymphedema can cause substantial morbidity. However, few studies have investigated longitudinal quality of life (QoL) outcomes in patients with postmastectomy lymphedema, especially with regard to surgical versus nonoperative management. This study prospectively investigated QoL in surgically versus nonsurgically managed patients with postmastectomy upper extremity lymphedema. Methods This was a longitudinal cohort study of breast cancer-related lymphedema patients at a single institution, between February 2017 and January 2020. Lymphedema Quality of Life Instrument (LyQLI) and RAND-36 QoL instrument were used. Mann–Whitney U and Fisher's exact tests were used for descriptive statistics. Wilcoxon's signed-rank testing and linear modeling were used to analyze longitudinal changes in QoL. Results Thirty-two lymphedema patients were recruited to the study (20 surgical and 12 nonsurgical). Surgical and nonsurgical cohorts did not significantly differ in clinical/demographic characteristics or baseline QoL scores, but at the 12-month time point surgical patients had significantly greater LyQLI overall health scores than nonsurgical patients (79.3 vs. 58.3, p = 0.02), as well as higher composite RAND-36 physical (68.5 vs. 38.3, p = 0.04), and mental (77.0 vs. 52.7, p = 0.02) scores. Furthermore, LyQLI overall health scores significantly improved over time in surgical patients (60.0 at baseline vs. 79.3 at 12 months, p = 0.04). Besides surgical treatment, race, and age were also found to significantly impact QoL on multivariable analysis. Conclusion Our results suggest that when compared with nonoperative management, surgery improved QoL for chronic, secondary upper extremity lymphedema patients within 12-month postoperatively. Our results also suggested that insurance status may have influenced decisions to undergo lymphedema surgery. Further study is needed to investigate the various sociodemographic factors that were also found to impact QoL outcomes in these lymphedema patients.

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Knowledge, Attitude and Practice of Physician toward Pelvic Floor Dysfunction KAP of Physician toward PFD

Journal of Gastroenterology & Digestive Systems ◽

10.33140/jgds.03.01.07 ◽

2019 ◽

Vol 3 (1) ◽

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Pelvic Organ ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Pelvic floor dysfunction (PFD) as a term includes underlying different sub-conditions the major ones are pelvic organ prolapse (POP), urinary incontinence (UI), fecal incontinence (FI), sexual function. The direct effect of dysfunction in these areas can affect the quality of life on a personal and healthy level in patients with PFD.

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An international collaborative design of clinical nursing practice guidelines for patients with cholangiocarcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.29_suppl.65 ◽

2015 ◽

Vol 33 (29_suppl) ◽

pp. 65-65

Author(s):

Susan Acquisto ◽

Renuka V. Iyer ◽

Karen M Driskill ◽

Natasha Pinheiro ◽

Jacqueline Weatherly ◽

...

Keyword(s):

Quality Of Life ◽

Practice Guidelines ◽

Nursing Practice ◽

Disease Process ◽

The United States ◽

Photon Radiation ◽

Evidence Based ◽

Clinical Nursing ◽

Key Aspects

65 Background: Cholangiocarcinoma (CC) accounts for approximately 3% of all gastrointestinal cancers and have a poor incident to mortality rate. The incidence in the United States (US) is 2,000-3,000 cases annually, with this rate steadily increasing during the last twenty years; this trend is not solely observed in US but also seen in Europe, Australia and Japan. The highest incidence is seen in Southeast Asia due to parasitic infection. CC presents many challenges to healthcare professionals due to the anatomic nature of CC (Lowe et al, 2015). The worldwide increase in incidence of CC is indication for the essential development of nursing practice guidelines underpinned by expert evidence and knowledge and regarding the key aspects of care. Methods: A collaboration of nursing professionals representing major cancer research institutions from around the country and the United Kingdom worked together to identify key aspects of care, the aim being to develop Clinical Nursing Practice Guidelines. The process included an exhaustive literature review using Pubmed, Uptodate, Medline, and CINAHL databases; submission of respective institutional practices; group consensus on guideline content, evidence-based scoring assignment and approval by the Cholangiocarcinoma Medical Advisory Board. Results: The guidelines developed include the care of the patient: (1) with external biliary drains and internal bile duct stents, (2) with intractable nausea and vomiting resulting from disease process, (3) with fatigue resulting from disease process, (4) undergoing chemotherapy, (5) undergoing photon radiation, (6) undergoing radiation on a clinical trial, and (7) preparing for liver transplantation. The purpose of the guidelines are to advance the scientific knowledge of the symptoms experienced, quality of life of patients with CCA, establish standards in patient care, and improve quality of care and satisfaction for patients diagnosed with CC. Conclusions: Creation of evidence-based guidelines will provide a springboard for expanded competent knowledge and a model to test for improvement in the care and quality of life of the patient with CC.

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Pelvic floor muscle exercise for fecal incontinence quality of life after coloanal anastomosis

Journal of Clinical Nursing ◽

10.1111/jocn.13314 ◽

2016 ◽

Vol 25 (17-18) ◽

pp. 2658-2668 ◽

Cited By ~ 3

Author(s):

Shu-Ling Hung ◽

Yu-Hua Lin ◽

Hsing-Yu Yang ◽

Chia-Chan Kao ◽

Hong-Yu Tung ◽

...

Keyword(s):

Quality Of Life ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Coloanal Anastomosis ◽

Pelvic Floor Muscle ◽

Muscle Exercise ◽

Pelvic Floor Muscle Exercise

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Development of a program for care during delivery for prevention of urinary incontinence

Impact ◽

10.21820/23987073.2020.7.19 ◽

2020 ◽

Vol 2020 (7) ◽

pp. 19-21

Author(s):

Katsuko Shinozaki

Keyword(s):

Quality Of Life ◽

Urinary Incontinence ◽

Pelvic Organ Prolapse ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Disorders ◽

Pelvic Organ ◽

New Mothers ◽

International University

Urinary incontinence after childbirth, which is also referred to as postpartum urinary incontinence, is the involuntary leaking of urine that can be experienced by new mothers. It can also occur during pregnancy and, either way, can have a dramatic impact on quality of life. In addition to urinary incontinence, there are a range of other pelvic floor disorders that can affect pregnant women and new mothers, including pelvic organ prolapse and fecal incontinence. Katsuko Shinozaki is a researcher based at the Postgraduate School of Health and Welfare Science at the International University of Health and Welfare, Japan. She is focusing her research on this issue. Shinozaki is developing a programme for care during childbirth for the prevention of urinary incontinence.

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Effect of Coexisting Pelvic Floor Disorders on Fecal Incontinence Quality of Life Scores

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000000459 ◽

2015 ◽

Vol 58 (11) ◽

pp. 1091-1097 ◽

Cited By ~ 14

Author(s):

Liliana Bordeianou ◽

Caitlin W. Hicks ◽

Adriana Olariu ◽

Lieba Savitt ◽

Samantha J. Pulliam ◽

...

Keyword(s):

Quality Of Life ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Disorders

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Recognition of Immune Response for the Early Diagnosis and Treatment of Osteoarthritis

Journal of Immunology Research ◽

10.1155/2015/192415 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 29

Author(s):

Adrese M. Kandahari ◽

Xinlin Yang ◽

Abhijit S. Dighe ◽

Dongfeng Pan ◽

Quanjun Cui

Keyword(s):

Quality Of Life ◽

Immune Response ◽

Early Diagnosis ◽

Imaging Techniques ◽

Disease Process ◽

Inflammatory Cells ◽

The United States ◽

Diagnosis And Treatment ◽

Joint Disease

Osteoarthritis is a common and debilitating joint disease that affects up to 30 million Americans, leading to significant disability, reduction in quality of life, and costing the United States tens of billions of dollars annually. Classically, osteoarthritis has been characterized as a degenerative, wear-and-tear disease, but recent research has identified it as an immunopathological disease on a spectrum between healthy condition and rheumatoid arthritis. A systematic literature review demonstrates that the disease pathogenesis is driven by an early innate immune response which progressively catalyzes degenerative changes that ultimately lead to an altered joint microenvironment. It is feasible to detect this infiltration of cells in the early, and presumably asymptomatic, phase of the disease through noninvasive imaging techniques. This screening can serve to aid clinicians in potentially identifying high-risk patients, hopefully leading to early effective management, vast improvements in quality of life, and significant reductions in disability, morbidity, and cost related to osteoarthritis. Although the diagnosis and treatment of osteoarthritis routinely utilize both invasive and non-invasive strategies, imaging techniques specific to inflammatory cells are not commonly employed for these purposes. This review discusses this paradigm and aims to shift the focus of future osteoarthritis-related research towards early diagnosis of the disease process.

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