Stuhlinkontinenz – vom Symptom zur Therapie

Stuhlinkontinenz stellt bis heute oft ein Tabuthema dar. Erste Symptome werden lange ignoriert und erst zunehmender Leidensdruck führt zur Vorstellung beim Arzt. Die Anamnese und die ergänzende klinische Untersuchung sind wegweisend für die Therapie. Meist lassen sich die Symptome durch konservative Therapien reduzieren, eine vollständige Normalisierung der anorektalen Kontinenzleistung ist selten möglich, auch nicht durch invasive Verfahren.

Abstract

Fecal incontinence (FI) is an escalating medical problem. Due to increasing life expectancy FI becomes more evident, especially in the geriatric population. The prevalence varies from 4 % in the adult population reaching > 50 % in the octogenerians, yet most probably associated with a significant based error due to underreporting. Diagnosis is depending primarily upon history taking and gathered information from the patient and caregivers. Additional technical diagnostic procedures are of secondary importance. In most cases no single cause for FI can be identified, mostly multifactorial disorders contribute to a progressive loss of anorectal continence. The mainstay in therapeutic approaches to control symptoms comprise changes in lifestyle patterns, physiotherapy and medical therapy, but depend on the patient’s compliance. Invasive or even surgical treatments are circumstantial, although sacral neuromodulation has proofed to be a successful treatment modality during the past decades. Ultimately a permanent stoma may lead to symptom control and result in an increased quality of life.

Schlüsselwörter

Stuhlinkontinenz - Geriatrie - Lebensqualität - Behandlungskonzepte - sakrale Neuromodulation

Key words

fecal incontinence - population characteristics - quality of life - diet therapy - new technologies

Publication History

Article published online:
22 July 2022

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