title: Does treatment of constipation improve faecal incontinence in institutionalized elderly patients?
abstract: OBJECTIVE
  to evaluate whether faecal incontinence can be improved by treatment of constipation in elderly patients with faecal incontinence associated with impairment of rectal emptying.
  
  
  METHODS
  a prospective randomized study with a 2-month follow-up.
  
  
  METHODS
  five long-term care units.
  
  
  METHODS
  206 patients with daily faecal incontinence associated with chronic rectal emptying impairments such as faecal impaction received either a single osmotic laxative (group I) or an osmotic agent along with a rectal stimulant and weekly enemas (group II).
  
  
  METHODS
  episodes of faecal incontinence and associated details of soiled laundry (used as indicators of the workload for caregivers). We performed periodic digital rectal examinations on group II patients to evaluate whether treatment resulted in complete and long-lasting rectal emptying. We compared data between groups and in group II between persistently constipated patients and patients with complete rectal emptying.
  
  
  RESULTS
  the frequency of faecal incontinence did not significantly differ between the two groups. The 23 patients in group II who had complete rectal emptying had 35% fewer episodes of faecal incontinence and 42% fewer incidents of soiled laundry than the rest of the group.
  
  
  CONCLUSIONS
  when long-lasting and complete rectal emptying is achieved by laxatives, the number of episodes of faecal incontinence as well as the workload for caregivers is reduced.
authors.affiliation: Service de Médecine Gériatrique, Centre Hospitalier et Universitaire de Rouen, France. medecine.geriatrique@chu-rouen.fr
authors.forename: P
authors.initials: P
authors.lastname: Chassagne
authors.forename: A
authors.initials: A
authors.lastname: Jego
authors.forename: P
authors.initials: P
authors.lastname: Gloc
authors.forename: C
authors.initials: C
authors.lastname: Capet
authors.forename: C
authors.initials: C
authors.lastname: Trivalle
authors.forename: J
authors.initials: J
authors.lastname: Doucet
authors.forename: P
authors.initials: P
authors.lastname: Denis
authors.forename: E
authors.initials: E
authors.lastname: Bercoff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003248:Constipation / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005242:Fecal Incontinence / Q000150:complications*; D005500:Follow-Up Studies; D005990:Glycerol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006707:Homes for the Aged; D006801:Humans; D007326:Institutionalization; D007792:Lactulose / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009735:Nursing Homes; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D002400:Cathartics; D007792:Lactulose; D005990:Glycerol