Functional Anorectal Disorders

Adil E. Bharucha, Arnold Wald, Paul Enck, Satish Sanku Chander Rao

Research output: Contribution to journalArticle

346 Citations (Scopus)

Abstract

This report defines criteria for diagnosing functional anorectal disorders (ie, fecal incontinence, anorectal pain, and disorders of defecation). Functional fecal incontinence is defined as the uncontrolled passage of fecal material recurring for ≥3 months in an individual with a developmental age of ≥4 years that is associated with: (1) abnormal functioning of normally innervated and structurally intact muscles, and/or (2) no or minor abnormalities of sphincter structure and/or innervation insufficient to explain fecal incontinence, and/or (3) normal or disordered bowel habits (ie, fecal retention or diarrhea), and/or (4) psychological causes. However, conditions wherein structural and/or neurogenic abnormalities explain the symptom, or are part of a generalized process (eg, diabetic neuropathy) are not included within functional fecal incontinence. Functional fecal incontinence is a common, but underrecognized symptom, which is equally prevalent in men and women, and can often cause considerable distress. The clinical features are useful for guiding diagnostic testing and therapy. Functional anorectal pain syndromes include proctalgia fugax (fleeting pain) and chronic proctalgia; chronic proctalgia may be subdivided into levator ani syndrome and unspecified anorectal pain, which are defined by arbitrary clinical criteria. Functional defecation disorders are characterized by 2 or more symptoms of constipation, with ≥2 of the following features during defecation: impaired evacuation, inappropriate contraction of the pelvic floor muscles, and inadequate propulsive forces. Functional disorders of defecation may be amenable to pelvic floor retraining by biofeedback therapy (such as dyssynergic defecation).

Original languageEnglish (US)
Pages (from-to)1510-1518
Number of pages9
JournalGastroenterology
Volume130
Issue number5
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

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Rectal Diseases
Fecal Incontinence
Defecation
Pelvic Floor
Pain
Muscles
Somatoform Disorders
Diabetic Neuropathies
Constipation
Chronic Pain
Habits
Diarrhea
Psychology
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Functional Anorectal Disorders. / Bharucha, Adil E.; Wald, Arnold; Enck, Paul; Rao, Satish Sanku Chander.

In: Gastroenterology, Vol. 130, No. 5, 01.01.2006, p. 1510-1518.

Research output: Contribution to journalArticle

Bharucha, AE, Wald, A, Enck, P & Rao, SSC 2006, 'Functional Anorectal Disorders', Gastroenterology, vol. 130, no. 5, pp. 1510-1518. https://doi.org/10.1053/j.gastro.2005.11.064
Bharucha, Adil E. ; Wald, Arnold ; Enck, Paul ; Rao, Satish Sanku Chander. / Functional Anorectal Disorders. In: Gastroenterology. 2006 ; Vol. 130, No. 5. pp. 1510-1518.
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