title: Conservative treatment of patients with faecal soiling.
abstract: OBJECTIVE
  A prospective evaluation of fifty patients with faecal soiling but normal sphincter function treated by a conservative treatment algorithm.
  
  
  METHODS
  Between January 2010 and January 2011, 50 consecutive patients of two different clinical centres, with faecal soiling and normal anorectal function as assessed by endoanal ultrasound, MRI and anal manometry, were eligible for the purpose of this study. All patients started the therapy by psyllium (PS) and a fibre-rich diet daily after 2 months followed by rectal irrigation (RI) in case of incomplete response and after 4 months by 4 g colestyramine (CO), respectively. The patients completed the Vaizey incontinence score and a 2-week diary card. All tests were performed repeated after 2, 4 and 8 months, respectively.
  
  
  RESULTS
  The study group consisted of 41 men and 9 women and a mean age of 38 years (21-70). The soiling complaints resolved completely in 37 (79%) patients. After treatment with PS, RI and CO, 12 (24%) patients, 24 (73%) patients and 1 (79%) patient, respectively, resolved completely of faecal soiling. Average weekly soiling frequency, the amount of patients wearing pads daily and the Vaizey incontinence score diminished significantly after treatment with psyllium and after treatment with rectal irrigation (P < 0.001).
  
  
  CONCLUSIONS
  Conservative treatment focussed on complete evacuation or clearing the anorectal canal is effective in the treatment of patients with faecal soiling.
authors: NPBC (Nederlands Proctologisch Bekkenbodem Centrum), Assen, The Netherlands. manonstephan@kpnplanet.nl
authors: S J
authors: SJ
authors: van der Hagen
authors: P B
authors: PB
authors: Soeters
authors: C G
authors: CG
authors: Baeten
authors: W G
authors: WG
authors: van Gemert
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001003:Anal Canal / Q000503:physiopathology; D000837:Anion Exchange Resins / Q000627:therapeutic use*; D002400:Cathartics / Q000627:therapeutic use*; D002792:Cholestyramine Resin / Q000627:therapeutic use*; D004043:Dietary Fiber / Q000008:administration & dosage*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011620:Psyllium / Q000627:therapeutic use*; D012007:Rectum / Q000503:physiopathology; D012720:Severity of Illness Index; D007507:Therapeutic Irrigation; D055815:Young Adult
chemical_list: D000837:Anion Exchange Resins; D002400:Cathartics; D004043:Dietary Fiber; D002792:Cholestyramine Resin; D011620:Psyllium