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Stuhlinkontinenz

Fecal incontinence

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Zusammenfassung

Stuhlinkontinenz ist ein vergleichsweise häufiges Krankheitsbild. Eine funktionierende Kontinenz beruht auf einem komplexen Zusammenspiel des zentralen, peripheren und autonomen Nervensystems mit einem funktionierenden Magen-Darm-Trakt und analen Sphinkterkomplex. Die Ursachen der Stuhlinkontinenz können angeboren oder erworben sein. Neben der genauen Abklärung der Inkontinenz(misch)form sind der Schweregrad der Erkrankung und das Ausmaß des subjektiven Leidens richtungsweisend. Oberstes Therapieziel sollte die subjektive Verbesserung der Symptomatik und somit eine Erhöhung der Lebensqualität sein. Bei einer erstmalig aufgetretenen Stuhlinkontinenz ohne Systemerkrankung empfiehlt sich eine konservative Herangehensweise. Bei erfolgloser konservativer Therapie oder einem Beckenbodenvorfall empfiehlt sich eine operative Therapie. Zusammenfassend gibt es keine Standardtherapie, optimal scheint jedoch eine Kombination aus chirurgischen und nichtchirurgischen Therapien zu sein.

Abstract

Fecal incontinence is a comparatively frequent clinical picture. A functioning continence consists of a complex interplay of the central, peripheral and autonomous nervous systems, a functioning gastrointestinal (GI) tract and anal sphincter complex. A distinction must be made between congenital and acquired fecal incontinence. In addition to the medical history the clinical examination is essential because the first consultation can often conclude on the nature of the problem. The ultimate goal of therapy should always be subjective improvement of symptoms thus increasing the individual quality of life. For the first occurrence of fecal incontinence without severe comorbidities a conservative therapy attempt is advisable. If the conservative therapy is not successful or pelvic floor incidents are present, surgical therapy is advisable. In summary there is no standard treatment but the optimal treatment seems to be a complex combination of surgical and non-surgical therapies.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Gingert und F.H. Hetzer geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Chirurgie, Kantonsspital, Geissbergstr. 81, 8208, Schaffhausen, Schweiz

    C. Gingert & F.H. Hetzer

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  1. C. Gingert
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  2. F.H. Hetzer
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Correspondence to C. Gingert.

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Gingert, C., Hetzer, F. Stuhlinkontinenz. coloproctology 36, 125–137 (2014). https://doi.org/10.1007/s00053-014-0439-8

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