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Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence

Patient: Female, 51 Final Diagnosis: Fecal incontinence Symptoms: Constipation • fecal incontinence Medication: — Clinical Procedure: Sacral nerve stimulator Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Fecal incontinence and constipatio...

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Autores principales: Sreepati, Gouri, James-Stevenson, Toyia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358841/
https://www.ncbi.nlm.nih.gov/pubmed/28265107
http://dx.doi.org/10.12659/AJCR.901821
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author Sreepati, Gouri
James-Stevenson, Toyia
author_facet Sreepati, Gouri
James-Stevenson, Toyia
author_sort Sreepati, Gouri
collection PubMed
description Patient: Female, 51 Final Diagnosis: Fecal incontinence Symptoms: Constipation • fecal incontinence Medication: — Clinical Procedure: Sacral nerve stimulator Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. CASE REPORT: A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction. Pelvic floor testing showed poor ability to squeeze the anal sphincter, which indicated sphincter weakness as a major contributor to her fecal incontinence symptoms. Additionally, on defecography she was unable to widen her posterior anorectal angle or relax the anal sphincter during defecation consistent with dyssynergic defecation. A sacral nerve stimulator was placed for management of her fecal incontinence. Interestingly, her constipation also dramatically improved with sacral neuromodulation. CONCLUSIONS: This unique case highlights the emerging role of sacral nerve stimulation in the treatment of complex pelvic floor dysfunction with improvement in symptoms beyond fecal incontinence in a patient with dyssynergic-type constipation.
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spelling pubmed-53588412017-03-29 Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence Sreepati, Gouri James-Stevenson, Toyia Am J Case Rep Articles Patient: Female, 51 Final Diagnosis: Fecal incontinence Symptoms: Constipation • fecal incontinence Medication: — Clinical Procedure: Sacral nerve stimulator Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. CASE REPORT: A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction. Pelvic floor testing showed poor ability to squeeze the anal sphincter, which indicated sphincter weakness as a major contributor to her fecal incontinence symptoms. Additionally, on defecography she was unable to widen her posterior anorectal angle or relax the anal sphincter during defecation consistent with dyssynergic defecation. A sacral nerve stimulator was placed for management of her fecal incontinence. Interestingly, her constipation also dramatically improved with sacral neuromodulation. CONCLUSIONS: This unique case highlights the emerging role of sacral nerve stimulation in the treatment of complex pelvic floor dysfunction with improvement in symptoms beyond fecal incontinence in a patient with dyssynergic-type constipation. International Scientific Literature, Inc. 2017-03-07 /pmc/articles/PMC5358841/ /pubmed/28265107 http://dx.doi.org/10.12659/AJCR.901821 Text en © Am J Case Rep, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
spellingShingle Articles
Sreepati, Gouri
James-Stevenson, Toyia
Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence
title Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence
title_full Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence
title_fullStr Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence
title_full_unstemmed Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence
title_short Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence
title_sort use of sacral nerve stimulation for the treatment of overlapping constipation and fecal incontinence
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358841/
https://www.ncbi.nlm.nih.gov/pubmed/28265107
http://dx.doi.org/10.12659/AJCR.901821
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