In this Part 1 issue, Definition, Epidemiology, Etiology, Pathophysiology and Causes, Risk factors, Clinical Evaluations, and symptomatic scores and QoL questionnaire for Clinical Evaluations are described. These guidelines contain many items and much volume therefore, we decided to report them in three parts: Part 1: Definition, Epidemiology, Etiology, Pathophysiology and Causes, Risk factors, Clinical Evaluations, and symptomatic scores and QoL questionnaire for Clinical Evaluations Part 2: Examination and Conservative Treatment and Part 3: Surgical Treatment and Fecal Incontinence under Special Conditions. The aims of these practice guidelines are to accomplish the following: 1) to understand concepts, pathophysiology and causes, diagnosis, and comprehensive treatments for FI 2) to promote the safety and efficacy of treatments 3) to reduce human and economic burdens of FI in practice and 4) to create mutual understanding between medical providers and patients. These guidelines were prepared not only for specialists who treat patients with FI, but also for general physicians, surgeons, and nurses. The Guideline Preparation Committee was composed of Society members in Japan who were chosen from the experts in this field. With increased clinical practice and demand for standardization, the Japan Society of Coloproctology decided to prepare practice guidelines for FI as there is no established research base of general practices in Japan. For the clinical evaluation of FI, it is useful to use Patient-Reported Outcome Measures (PROMs), such as scores and questionnaires, to evaluate the symptomatic severity of FI and its influence over quality of life (QoL).įecal incontinence (FI) is a defecation disorder which disturbs daily quality of life. Following the general physical examination, together with history taking, inspection (including anoscope), and palpation (including digital anorectal and vaginal examination) of the anorectal area, clinicians can focus on the causes of FI. The evaluation is the basis of all medical treatments for FI, including initial treatment, and also serves as a baseline for deciding the need for a specialized defecation function test and selecting treatment in stages. In the initial clinical evaluation of FI, the factors responsible for individual symptoms are gathered from the history and examination of the anorectal region. The etiology of FI is usually not limited to one specific cause, with risk factors for FI including physiological factors, such as age and gender comorbidities, such as diabetes and irritable bowel syndrome and obstetric factors, such as multiple deliveries, home delivery, first vaginal delivery, and forceps delivery. The prevalence of FI in people over 65 in Japan is 8.7% in the male population and 6.6% among females. Gas incontinence is defined as involuntary or uncontrollable loss of flatus, while anal incontinence is defined as the involuntary loss of feces or flatus. Fecal incontinence (FI) is defined as involuntary or uncontrollable loss of feces.
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