Current concepts: fecal impaction

Article Abstract:

Impaction of feces in the bowel (fecal impaction) is particularly common and often overlooked among incapacitated, institutionalized elderly people, the mentally ill, those with kidney failure, cancer patients and patients with neurological impairment. There are many possible causes for fecal impaction, but diet is the single most important factor regulating function of the colon. Among the elderly and infirm, sensory function of the rectum and anus is often reduced, decreasing the usual sensation of rectal distension (stretching) that precedes bowel evacuation. Typical symptoms associated with fecal impaction are loss of appetite, vomiting, nausea and abdominal pain. An X-ray examination of the colon may reveal masses of stool or signs of bowel obstruction, a frequent complication. Prevention is considered the best treatment for fecal impaction. Adequate amounts of dietary fiber and carbohydrates, proper fluid intake, adequate exercise, treatment of underlying diseases and changes in medication or in environment will often prevent fecal impaction. Simple measures, such as making bathroom facilities easier to use for those who cannot walk, can also be helpful. Preventive measures are likely to be cost-effective in populations with high risk for fecal impaction. Regular use of laxatives or enemas in patients with severe constipation may be necessary at times, but this approach should be used with caution.

Feces, Fecal impaction

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Fecal incontinence

Article Abstract:

Fecal incontinence is most common among elderly individuals, but is also common among institutionalized patients. Many patients with this disorder are embarrassed to report their symptoms to their physician, and many go without treatment. Normal fecal continence depends on proper function of the brain, the colon, the rectum and the sphincter of the anus, and on the amount and consistency of feces produced. A wide variety of medical conditions may cause fecal incontinence. Individuals with conditions that such as diabetes that cause abnormal function of the nervous system may develop fecal incontinence. Fecal incontinence of unknown cause occurs most commonly in women. Individuals with fecal incontinence usually undergo a rectal examination and different physiological and radiologic tests to determine the underlying cause. Patients with fecal incontinence are treated with dietary therapy, drugs, biofeedback and surgery. Many patients with fecal incontinence have an underlying disorder such as gastrointestinal disease that should be treated. Patients who do not respond to treatment usually undergo a colostomy.

Care and treatment, Fecal incontinence

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The changing concepts of Guillain-Barre syndrome

Article Abstract:

The association of Guillain-Barre syndrome with Campylobacter (C.) jejuni may help explain the mechanism and affect the outcome of the syndrome but may not affect prevention strategies. Guillain-Barre syndrome results in sudden paralysis due to inflammation of nerves, loss of the sheath surrounds nerves, or deterioration of nerve cells. A 1995 study found that 26% of 96 patients with Guillain-Barre syndrome had had a previous C. jejuni infection. The patients who had more severe cases of the syndrome and took longer to recover tended to have the infection. These findings suggest the that the immune response launched against C. jejuni may proceed to attack nerve cells as well. However, measures to actively treat the relatively harmless C. jejuni infection may not be worthwhile because the infection often may not lead to Guillain-Barre. However, patients with Guillain-Barre may be tested for the infection in order to aid in diagnosis.

Editorial, Complications and side effects, Physiological aspects, Guillain-Barre syndrome, Campylobacter infections, Campylobacteriosis

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