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Erschienen in: Current Geriatrics Reports 2/2017

04.05.2017 | Geriatric Urology (H Richter, Section Editor)

Epidemiology, Pathophysiology and Management of Fecal Incontinence in the Older Woman

verfasst von: Isuzu Meyer, Lindsay Kissane

Erschienen in: Current Geriatrics Reports | Ausgabe 2/2017

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Abstract

Purpose of Review

To review up-to-date management of fecal incontinence in older women, highlighting age-related issues.

Recent Findings

Fecal incontinence is highly prevalent in older women. The etiology is multifactorial; however, advanced age itself has been found to be an independent risk factor. Understanding age-related physiologic and anatomic changes and unique challenges in the geriatric population is critical in order to offer effective therapy. Evaluation should start with obtaining a thorough history and physical examination, and diagnostic tests should be reserved for refractory symptoms or specific conditions. Simple conservative approaches can be effective and should be offered without diagnostic testing. More treatment options have recently become available or are currently being investigated in an effort to provide higher long-term efficacy and safety.

Summary

Treatment of fecal incontinence in older women can be challenging and often complicated by decreased health and functional status. Management should be individualized based on the patient’s health status, clinical setting (ambulatory versus institutionalized), preference, and goals of therapy.
Literatur
1.
Zurück zum Zitat Dunivan GC, Heyman S, Palsson OS, von Korff M, Turner MJ, Melville JL, et al. Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol. 2010;202(5):493.e1–6. doi:10.1016/j.ajog.2010.01.018.CrossRef Dunivan GC, Heyman S, Palsson OS, von Korff M, Turner MJ, Melville JL, et al. Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol. 2010;202(5):493.e1–6. doi:10.​1016/​j.​ajog.​2010.​01.​018.CrossRef
2.
Zurück zum Zitat Johanson JF, Lafferty J. Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol. 1996;91(1):33–6.PubMed Johanson JF, Lafferty J. Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol. 1996;91(1):33–6.PubMed
4.
5.
Zurück zum Zitat • Halland M, Koloski NA, Jones M, Byles J, Chiarelli P, Forder P, et al. Prevalence correlates and impact of fecal incontinence among older women. Dis Colon Rectum. 2013;56(9):1080–6. doi:10.1097/DCR.0b013e31829203a9. This large cross-sectional study identifies risk factors associated with FI in community- and institutional-dwelling elderly women including diabetes, depression, and urinary incontinence CrossRefPubMed • Halland M, Koloski NA, Jones M, Byles J, Chiarelli P, Forder P, et al. Prevalence correlates and impact of fecal incontinence among older women. Dis Colon Rectum. 2013;56(9):1080–6. doi:10.​1097/​DCR.​0b013e31829203a9​. This large cross-sectional study identifies risk factors associated with FI in community- and institutional-dwelling elderly women including diabetes, depression, and urinary incontinence CrossRefPubMed
8.
Zurück zum Zitat •• Wu JM, Matthews CA, Vaughan CP, Markland AD. Urinary, fecal, and dual incontinence in older U.S. adults. J Am Geriatr Soc. 2015;63(5):947–53. doi:10.1111/jgs.13385. This large cross-sectional study estimates the prevalence of dual incontinence in community-dwelling adults age 50 and older, and identifies specific factors associated with UI, FI and dual incontinence CrossRefPubMedPubMedCentral •• Wu JM, Matthews CA, Vaughan CP, Markland AD. Urinary, fecal, and dual incontinence in older U.S. adults. J Am Geriatr Soc. 2015;63(5):947–53. doi:10.​1111/​jgs.​13385. This large cross-sectional study estimates the prevalence of dual incontinence in community-dwelling adults age 50 and older, and identifies specific factors associated with UI, FI and dual incontinence CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Yip SO, Dick MA, McPencow AM, Martin DK, Ciarleglio MM, Erekson EA. The association between urinary and fecal incontinence and social isolation in older women. Am J Obstet Gynecol. 2013;208(2):146 e1–7. doi:10.1016/j.ajog.2012.11.010.CrossRef Yip SO, Dick MA, McPencow AM, Martin DK, Ciarleglio MM, Erekson EA. The association between urinary and fecal incontinence and social isolation in older women. Am J Obstet Gynecol. 2013;208(2):146 e1–7. doi:10.​1016/​j.​ajog.​2012.​11.​010.CrossRef
11.
Zurück zum Zitat Boreham MK, Richter HE, Kenton KS, Nager CW, Gregory WT, Aronson MP, et al. Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol. 2005;192(5):1637–42. doi:10.1016/j.ajog.2004.11.030.CrossRefPubMed Boreham MK, Richter HE, Kenton KS, Nager CW, Gregory WT, Aronson MP, et al. Anal incontinence in women presenting for gynecologic care: prevalence, risk factors, and impact upon quality of life. Am J Obstet Gynecol. 2005;192(5):1637–42. doi:10.​1016/​j.​ajog.​2004.​11.​030.CrossRefPubMed
12.
Zurück zum Zitat Cassells C, Watt E. The impact of incontinence on older spousal caregivers. J Adv Nurs. 2003;42(6):607–16.CrossRefPubMed Cassells C, Watt E. The impact of incontinence on older spousal caregivers. J Adv Nurs. 2003;42(6):607–16.CrossRefPubMed
14.
Zurück zum Zitat Friedman SM, Steinwachs DM, Rathouz PJ, Burton LC, Mukamel DB. Characteristics predicting nursing home admission in the program of all-inclusive care for elderly people. Gerontologist. 2005;45(2):157–66.CrossRefPubMed Friedman SM, Steinwachs DM, Rathouz PJ, Burton LC, Mukamel DB. Characteristics predicting nursing home admission in the program of all-inclusive care for elderly people. Gerontologist. 2005;45(2):157–66.CrossRefPubMed
16.
19.
Zurück zum Zitat Wang JY, Patterson TR, Hart SL, Varma MG. Fecal incontinence: does age matter? Characteristics of older vs. younger women presenting for treatment of fecal incontinence. Dis Colon Rectum. 2008;51(4):426–31. doi:10.1007/s10350-007-9138-7.CrossRefPubMed Wang JY, Patterson TR, Hart SL, Varma MG. Fecal incontinence: does age matter? Characteristics of older vs. younger women presenting for treatment of fecal incontinence. Dis Colon Rectum. 2008;51(4):426–31. doi:10.​1007/​s10350-007-9138-7.CrossRefPubMed
22.
Zurück zum Zitat Teunissen TA, van den Bosch WJ, van den Hoogen HJ, Lagro-Janssen AL. Prevalence of urinary, fecal and double incontinence in the elderly living at home. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(1):10–3. doi:10.1007/s00192-003-1106-8.CrossRefPubMed Teunissen TA, van den Bosch WJ, van den Hoogen HJ, Lagro-Janssen AL. Prevalence of urinary, fecal and double incontinence in the elderly living at home. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(1):10–3. doi:10.​1007/​s00192-003-1106-8.CrossRefPubMed
23.
Zurück zum Zitat Selcuk S, Cam C, Asoglu MR, Karateke A. The effect of concealed concomitant anal incontinence symptoms in patients with urinary incontinence on their quality of life. Int Urogynecol J. 2012;23(12):1781–4. doi:10.1007/s00192-012-1808-x.CrossRefPubMed Selcuk S, Cam C, Asoglu MR, Karateke A. The effect of concealed concomitant anal incontinence symptoms in patients with urinary incontinence on their quality of life. Int Urogynecol J. 2012;23(12):1781–4. doi:10.​1007/​s00192-012-1808-x.CrossRefPubMed
27.
28.
Zurück zum Zitat Lestar B, Penninckx F, Kerremans R. The composition of anal basal pressure. An in vivo and in vitro study in man. Int J Color Dis. 1989;4(2):118–22.CrossRef Lestar B, Penninckx F, Kerremans R. The composition of anal basal pressure. An in vivo and in vitro study in man. Int J Color Dis. 1989;4(2):118–22.CrossRef
32.
34.
Zurück zum Zitat Cooper EA, De-Loyde KJ, Young CJ, Shepherd HL, Wright C. Pudendal nerve testing does not contribute to surgical decision making following anorectal testing in patients with faecal incontinence. Int J Color Dis. 2016;31(8):1437–42. doi:10.1007/s00384-016-2617-3.CrossRef Cooper EA, De-Loyde KJ, Young CJ, Shepherd HL, Wright C. Pudendal nerve testing does not contribute to surgical decision making following anorectal testing in patients with faecal incontinence. Int J Color Dis. 2016;31(8):1437–42. doi:10.​1007/​s00384-016-2617-3.CrossRef
36.
Zurück zum Zitat Schnelle JF, Leung FW. Urinary and fecal incontinence in nursing homes. Gastroenterology. 2004;126(1):S41–7.CrossRefPubMed Schnelle JF, Leung FW. Urinary and fecal incontinence in nursing homes. Gastroenterology. 2004;126(1):S41–7.CrossRefPubMed
38.
Zurück zum Zitat Whitehead WE, Wald A, Norton NJ. Treatment options for fecal incontinence. Dis Colon Rectum. 2001;44(1):131–144 Whitehead WE, Wald A, Norton NJ. Treatment options for fecal incontinence. Dis Colon Rectum. 2001;44(1):131–144
39.
Zurück zum Zitat Ouslander JG, Simmons S, Schnelle J, Uman G, Fingold S. Effects of prompted voiding on fecal continence among nursing home residents. J Am Geriatr Soc. 1996;44(4):424–8.CrossRefPubMed Ouslander JG, Simmons S, Schnelle J, Uman G, Fingold S. Effects of prompted voiding on fecal continence among nursing home residents. J Am Geriatr Soc. 1996;44(4):424–8.CrossRefPubMed
40.
Zurück zum Zitat Schnelle JF, Kapur K, Alessi C, Osterweil D, Beck JG, Al-Samarrai NR. Does an exercise and incontinence intervention save healthcare costs in a nursing home population? J Am Geriatr Soc. 2003;51(2):161–8.CrossRefPubMed Schnelle JF, Kapur K, Alessi C, Osterweil D, Beck JG, Al-Samarrai NR. Does an exercise and incontinence intervention save healthcare costs in a nursing home population? J Am Geriatr Soc. 2003;51(2):161–8.CrossRefPubMed
46.
Zurück zum Zitat •• Markland AD, Burgio KL, Whitehead WE, Richter HE, Wilcox CM, Redden DT. Loperamide versus psyllium fiber for treatment of fecal incontinence: the Fecal Incontinence prescription (Rx) Management (FIRM) randomized clinical trial. Dis Colon Rectum. 2015;58(10):983–93. doi:10.1097/DCR.0000000000000442. This randomized, double blind, placebo-controlled, crossover trial compared loperamide and psyllium fiber for treatment of FI in community-dwelling adults, and found both treatments to improve symptom severity and QOL. Loperamide was associated with more headache and constipation CrossRefPubMed •• Markland AD, Burgio KL, Whitehead WE, Richter HE, Wilcox CM, Redden DT. Loperamide versus psyllium fiber for treatment of fecal incontinence: the Fecal Incontinence prescription (Rx) Management (FIRM) randomized clinical trial. Dis Colon Rectum. 2015;58(10):983–93. doi:10.​1097/​DCR.​0000000000000442​. This randomized, double blind, placebo-controlled, crossover trial compared loperamide and psyllium fiber for treatment of FI in community-dwelling adults, and found both treatments to improve symptom severity and QOL. Loperamide was associated with more headache and constipation CrossRefPubMed
47.
Zurück zum Zitat Jelovsek EJ, Markland AD, Whitehead WE, Barber MD, Newman DK, Rogers RG, et al. Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: design and methods. Contemp Clin Trials. 2015;44:164–74. doi:10.1016/j.cct.2015.08.009.CrossRefPubMedCentral Jelovsek EJ, Markland AD, Whitehead WE, Barber MD, Newman DK, Rogers RG, et al. Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: design and methods. Contemp Clin Trials. 2015;44:164–74. doi:10.​1016/​j.​cct.​2015.​08.​009.CrossRefPubMedCentral
48.
Zurück zum Zitat Palmer KR, Corbett CL, Holdsworth CD. Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology. 1980;79(6):1272–5.PubMed Palmer KR, Corbett CL, Holdsworth CD. Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology. 1980;79(6):1272–5.PubMed
49.
Zurück zum Zitat American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–46. doi:10.1111/jgs.13702.CrossRef American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–46. doi:10.​1111/​jgs.​13702.CrossRef
50.
Zurück zum Zitat Remes-Troche JM, Ozturk R, Philips C, Stessman M, Rao SS. Cholestyramine—a useful adjunct for the treatment of patients with fecal incontinence. Int J Color Dis. 2008;23(2):189–94. doi:10.1007/s00384-007-0391-y.CrossRef Remes-Troche JM, Ozturk R, Philips C, Stessman M, Rao SS. Cholestyramine—a useful adjunct for the treatment of patients with fecal incontinence. Int J Color Dis. 2008;23(2):189–94. doi:10.​1007/​s00384-007-0391-y.CrossRef
51.
Zurück zum Zitat Malcolm A, Camilleri M, Kost L, Burton DD, Fett SL, Zinsmeister AR. Towards identifying optimal doses for alpha-2 adrenergic modulation of colonic and rectal motor and sensory function. Aliment Pharmacol Ther. 2000;14(6):783–93.CrossRefPubMed Malcolm A, Camilleri M, Kost L, Burton DD, Fett SL, Zinsmeister AR. Towards identifying optimal doses for alpha-2 adrenergic modulation of colonic and rectal motor and sensory function. Aliment Pharmacol Ther. 2000;14(6):783–93.CrossRefPubMed
53.
Zurück zum Zitat Graf W, Mellgren A, Matzel KE, Hull T, Johansson C, Bernstein M. Efficacy of dextranomer in stabilised hyaluronic acid for treatment of faecal incontinence: a randomised, sham-controlled trial. Lancet. 2011;377(9770):997–1003. doi:10.1016/S0140-6736(10)62297-0.CrossRefPubMed Graf W, Mellgren A, Matzel KE, Hull T, Johansson C, Bernstein M. Efficacy of dextranomer in stabilised hyaluronic acid for treatment of faecal incontinence: a randomised, sham-controlled trial. Lancet. 2011;377(9770):997–1003. doi:10.​1016/​S0140-6736(10)62297-0.CrossRefPubMed
56.
Zurück zum Zitat Dehli T, Stordahl A, Vatten LJ, Romundstad PR, Mevik K, Sahlin Y, et al. Sphincter training or anal injections of dextranomer for treatment of anal incontinence: a randomized trial. Scand J Gastroenterol. 2013;48(3):302–10. doi:10.3109/00365521.2012.758770.CrossRefPubMed Dehli T, Stordahl A, Vatten LJ, Romundstad PR, Mevik K, Sahlin Y, et al. Sphincter training or anal injections of dextranomer for treatment of anal incontinence: a randomized trial. Scand J Gastroenterol. 2013;48(3):302–10. doi:10.​3109/​00365521.​2012.​758770.CrossRefPubMed
58.
Zurück zum Zitat • Lukacz ES, Segall MM, Wexner SD. Evaluation of an anal insert device for the conservative management of fecal incontinence. Dis Colon Rectum. 2015;58(9):892–8. doi:10.1097/DCR.0000000000000427. This multicenter, single-arm cohort study reported high patient satisfaction, improvement in FI severity, no serious adverse events using a new anal insert device for fecal incontinence CrossRefPubMed • Lukacz ES, Segall MM, Wexner SD. Evaluation of an anal insert device for the conservative management of fecal incontinence. Dis Colon Rectum. 2015;58(9):892–8. doi:10.​1097/​DCR.​0000000000000427​. This multicenter, single-arm cohort study reported high patient satisfaction, improvement in FI severity, no serious adverse events using a new anal insert device for fecal incontinence CrossRefPubMed
60.
Zurück zum Zitat • Richter HE, Matthews CA, Muir T, Takase-Sanchez MM, Hale DS, Van Drie D, et al. A vaginal bowel-control system for the treatment of fecal incontinence. Obstet Gynecol. 2015;125(3):540–7. doi:10.1097/AOG.0000000000000639. This single-arm prospective cohort study reported high efficacy and patient satisfaction with no serious adverse events using a new nonsurgical vaginal bowel-control device for treatment of FI CrossRefPubMed • Richter HE, Matthews CA, Muir T, Takase-Sanchez MM, Hale DS, Van Drie D, et al. A vaginal bowel-control system for the treatment of fecal incontinence. Obstet Gynecol. 2015;125(3):540–7. doi:10.​1097/​AOG.​0000000000000639​. This single-arm prospective cohort study reported high efficacy and patient satisfaction with no serious adverse events using a new nonsurgical vaginal bowel-control device for treatment of FI CrossRefPubMed
63.
Zurück zum Zitat Fang DT, Nivatvongs S, Vermeulen FD, Herman FN, Goldberg SM, Rothenberger DA. Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum. 1984;27(11):720–2.CrossRefPubMed Fang DT, Nivatvongs S, Vermeulen FD, Herman FN, Goldberg SM, Rothenberger DA. Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum. 1984;27(11):720–2.CrossRefPubMed
64.
Zurück zum Zitat Oberwalder M, Dinnewitzer A, Baig MK, Nogueras JJ, Weiss EG, Efron J, et al. Do internal anal sphincter defects decrease the success rate of anal sphincter repair? Tech Coloproctol. 2006;10(2):94–7. doi:10.1007/s10151-006-0259-0.CrossRefPubMed Oberwalder M, Dinnewitzer A, Baig MK, Nogueras JJ, Weiss EG, Efron J, et al. Do internal anal sphincter defects decrease the success rate of anal sphincter repair? Tech Coloproctol. 2006;10(2):94–7. doi:10.​1007/​s10151-006-0259-0.CrossRefPubMed
65.
Zurück zum Zitat Wexner SD, Marchetti F, Jagelman DG. The role of sphincteroplasty for fecal incontinence reevaluated: a prospective physiologic and functional review. Dis Colon Rectum. 1991;34(1):22–30.CrossRefPubMed Wexner SD, Marchetti F, Jagelman DG. The role of sphincteroplasty for fecal incontinence reevaluated: a prospective physiologic and functional review. Dis Colon Rectum. 1991;34(1):22–30.CrossRefPubMed
70.
71.
72.
Zurück zum Zitat Patton V, Wiklendt L, Arkwright JW, Lubowski DZ, Dinning PG. The effect of sacral nerve stimulation on distal colonic motility in patients with faecal incontinence. Br J Surg. 2013;100(7):959–68. doi:10.1002/bjs.9114.CrossRefPubMed Patton V, Wiklendt L, Arkwright JW, Lubowski DZ, Dinning PG. The effect of sacral nerve stimulation on distal colonic motility in patients with faecal incontinence. Br J Surg. 2013;100(7):959–68. doi:10.​1002/​bjs.​9114.CrossRefPubMed
73.
Zurück zum Zitat Uludağ O, Koch SM, van Gemert WG, Dejong CH, Baeten CG. Sacral neuromodulation in patients with fecal incontinence: a single-center study. Dis Colon Rectum. 2004;47(8):1350–7.CrossRefPubMed Uludağ O, Koch SM, van Gemert WG, Dejong CH, Baeten CG. Sacral neuromodulation in patients with fecal incontinence: a single-center study. Dis Colon Rectum. 2004;47(8):1350–7.CrossRefPubMed
75.
Zurück zum Zitat Vaizey CJ, Kamm MA, Turner IC, Nicholls RJ, Woloszko J. Effects of short term sacral nerve stimulation on anal and rectal function in patients with anal incontinence. Gut. 1999;44(3):407–12.CrossRefPubMedPubMedCentral Vaizey CJ, Kamm MA, Turner IC, Nicholls RJ, Woloszko J. Effects of short term sacral nerve stimulation on anal and rectal function in patients with anal incontinence. Gut. 1999;44(3):407–12.CrossRefPubMedPubMedCentral
76.
Zurück zum Zitat Rasmussen OO, Buntzen S, Sørensen M, Laurberg S, Christiansen J. Sacral nerve stimulation in fecal incontinence. Dis Colon Rectum. 2004;47(7):1158–63.CrossRefPubMed Rasmussen OO, Buntzen S, Sørensen M, Laurberg S, Christiansen J. Sacral nerve stimulation in fecal incontinence. Dis Colon Rectum. 2004;47(7):1158–63.CrossRefPubMed
77.
79.
Zurück zum Zitat Amundsen CL, Romero AA, Jamison MG, Webster GD. Sacral neuromodulation for intractable urge incontinence: are there factors associated with cure? Urology. 2005;66(4):746–50.CrossRefPubMed Amundsen CL, Romero AA, Jamison MG, Webster GD. Sacral neuromodulation for intractable urge incontinence: are there factors associated with cure? Urology. 2005;66(4):746–50.CrossRefPubMed
80.
Zurück zum Zitat Thin NN, Horrocks EJ, Hotouras A, Palit S, Thaha MA, Chan CL, et al. Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence. Br J Surg. 2013;100(11):1430–47. doi:10.1002/bjs.9226.CrossRefPubMed Thin NN, Horrocks EJ, Hotouras A, Palit S, Thaha MA, Chan CL, et al. Systematic review of the clinical effectiveness of neuromodulation in the treatment of faecal incontinence. Br J Surg. 2013;100(11):1430–47. doi:10.​1002/​bjs.​9226.CrossRefPubMed
81.
Zurück zum Zitat Knowles CH, Horrocks EJ, Bremner SA, Stevens N, Norton C, O’Connell PR, et al. Percutaneous tibial nerve stimulation versus sham electrical stimulation for the treatment of faecal incontinence in adults (CONFIDeNT): a double-blind, multicentre, pragmatic, parallel-group, randomised controlled trial. Lancet. 2015;386(10004):1640–8. doi:10.1016/S0140-6736(15)60314-2.CrossRefPubMed Knowles CH, Horrocks EJ, Bremner SA, Stevens N, Norton C, O’Connell PR, et al. Percutaneous tibial nerve stimulation versus sham electrical stimulation for the treatment of faecal incontinence in adults (CONFIDeNT): a double-blind, multicentre, pragmatic, parallel-group, randomised controlled trial. Lancet. 2015;386(10004):1640–8. doi:10.​1016/​S0140-6736(15)60314-2.CrossRefPubMed
83.
Zurück zum Zitat Johnson TM, Ouslander JG, Uman GC, Schnelle JF. Urinary incontinence treatment preferences in long-term care. J Am Geriatr Soc. 2001;49(6):710–8.CrossRefPubMed Johnson TM, Ouslander JG, Uman GC, Schnelle JF. Urinary incontinence treatment preferences in long-term care. J Am Geriatr Soc. 2001;49(6):710–8.CrossRefPubMed
84.
Zurück zum Zitat Kottner J, Beeckman D. Incontinence-associated dermatitis and pressure ulcers in geriatric patients. G Ital Dermatol Venereol. 2015;150(6):717–29.PubMed Kottner J, Beeckman D. Incontinence-associated dermatitis and pressure ulcers in geriatric patients. G Ital Dermatol Venereol. 2015;150(6):717–29.PubMed
85.
Zurück zum Zitat Beeckman D, Van Damme N, Schoonhoven L, Van Lancker A, Kottner J, Beele H, Gray M, et al. Interventions for preventing and treating incontinence-associated dermatitis in adults. Cochrane Database Syst Rev. 2016;11:CD011627. doi:10.1002/14651858.CD011627.pub2.PubMed Beeckman D, Van Damme N, Schoonhoven L, Van Lancker A, Kottner J, Beele H, Gray M, et al. Interventions for preventing and treating incontinence-associated dermatitis in adults. Cochrane Database Syst Rev. 2016;11:CD011627. doi:10.​1002/​14651858.​CD011627.​pub2.PubMed
Metadaten
Titel
Epidemiology, Pathophysiology and Management of Fecal Incontinence in the Older Woman
verfasst von
Isuzu Meyer
Lindsay Kissane
Publikationsdatum
04.05.2017
Verlag
Springer US
Erschienen in
Current Geriatrics Reports / Ausgabe 2/2017
Elektronische ISSN: 2196-7865
DOI
https://doi.org/10.1007/s13670-017-0201-5

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