Diagnosis and treatment of faecal incontinence: Consensus statement of the Italian Society of Colorectal Surgery and the Italian Association of Hospital Gastroenterologists.
Faecal incontinence is a common and disturbing condition, which leads to impaired quality of life and huge social and economic costs. Although recent studies have identified novel diagnostic modalities and therapeutic options, the best diagnostic and therapeutic approach is not yet completely known and shared among experts in this field. The Italian Society of Colorectal Surgery and the Italian Association of Hospital Gastroenterologists selected a pool of experts to constitute a joint committee on the basis of their experience in treating pelvic floor disorders. The aim was to develop a position paper on the diagnostic and therapeutic aspects of faecal incontinence, to provide practical recommendations for a cost-effective diagnostic work-up and a tailored treatment strategy. The recommendations were defined and graded on the basis of levels of evidence in accordance with the criteria of the Oxford Centre for Evidence-Based Medicine, and were based on currently published scientific evidence. Each statement was drafted through constant communication and evaluation conducted both online and during face-to-face working meetings. A brief recommendation at the end of each paragraph allows clinicians to find concise responses to each diagnostic and therapeutic issue.
Department of Surgery and Translational Medicine, University of Florence, Italy. Electronic address: pucciani@unifi.it.
Filippo
F
Pucciani
Department of Emergency and Organ Transplantation, University of Bari, Italy.
Donato Francesco
DF
Altomare
Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.
Giuseppe
G
Dodi
I Division of Surgical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Italy.
Ezio
E
Falletto
Department of Surgery, Oncology and Gastroenterology, University of Padua, Italy.
Alvise
A
Frasson
Proctological and Perineal Surgical Unit, University Hospital of Pisa, Italy.
Iacopo
I
Giani
General, Emergency and Minimally Invasive Surgery, Careggi University Hospital, Florence, Italy.
Jacopo
J
Martellucci
Proctological and Perineal Surgical Unit, University Hospital of Pisa, Italy.
Gabriele
G
Naldini
Diagnostic Imaging Centre, Villa Igea Clinic, Ancona, Italy.
Vittorio
V
Piloni
General and Geriatric Surgery Unit, School of Medicine, Second University of Naples, Italy.
Guido
G
Sciaudone
Gastroenterology and Endoscopy Unit, Department of Gastroenterology - AORN "A. Cardarelli", Naples, Italy.
Antonio
A
Bove
Gastrointestinal Physiopathology, Gastroenterology Department, Malatesta Novello Private Hospital, Cesena, Italy.
Renato
R
Bocchini
Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Italy.
Massimo
M
Bellini
Digestive Endoscopy Unit, San Luca Hospital, Lucca, Italy.
Pietro
P
Alduini
Gastroenterology and Endoscopy Unit, Cardinal Massaia Hospital, Asti, Italy.
Edda
E
Battaglia
Gastroenterology Unit, Padua University-Hospital, Padua, Italy.
Francesca
F
Galeazzi
Gastroenterology Unit, S.M. della Misericordia University Hospital, Udine, Italy.
Piera
P
Rossitti
Gastroenterology Unit, Brotzu Hospital, Cagliari, Italy.
Paolo
P
Usai Satta
D001003:Anal Canal / Q000601:surgery; D000930:Antidiarrheals / Q000627:therapeutic use; D003107:Colorectal Surgery; D004599:Electric Stimulation Therapy; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007443:Intussusception / Q000601:surgery; D007558:Italy; D054368:Laxatives / Q000627:therapeutic use; D011788:Quality of Life; D012005:Rectal Prolapse / Q000601:surgery; D012720:Severity of Illness Index
D000930:Antidiarrheals; D054368:Laxatives
Anorectal manometry; Biofeedback; Endoanal ultrasonography; Faecal incontinence; Post anal repair; Rectopexy; Sphincteroplasty