Introduction Due to advances in critical care medicine and spine surgery techniques in the last few decades, more individuals survive severe trauma that result in spinal injuries. This resulted in seven articles eligible for the topic to be reviewed; however, after excluding two commentaries, five studies were included into the final review: three pilot studies and two randomized controlled trials (Figure 1 and Table 1). Chapter 9: analyzing data and undertaking meta-analyses. Pelvic floor dysfunction is a common condition where you're unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or to have a bowel movement. sharing sensitive information, make sure youre on a federal Benezech A., Bouvier M., Vitton V. Faecal incontinence: Current knowledges and perspectives. According to Chinese medicine, all healthy human body structures are in balance of Yin and Yang powers. Treatment options include conservative methods, covering personal hygiene, diet control, pharmacological therapy, physiotherapy techniques for pelvic floor muscles, percutaneous tibial nerve stimulation (PTNS), transanal irrigation (TAI), and anal plug usage; minimal invasive means, including sacral neuromodulation (SNM), antegrade irrigation, anal radiofrequency (SECCA), and intrasphincteric injections; and surgical approaches, including sphincter repair, graciloplasty, artificial sphincter, and colostomy. Guangxi . The methodological and conceptual quality of the reviewed studies were assessed according to the Robins I and GRADE (Table 2) [13,14]. The search term consisted of two parts: intervention method and disease: (electroacupuncture therapy or acupuncture or laser acupuncture or warm acupuncture or electroacupuncture or acupuncture therapy or moxibostustion or laser acupuncture therapy or warm acupuncture therapy) and (fecal incontinence or FI or encopresis or defecation incontinence or diarrhea or bowel dysfunction). Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupuncture for patients with fecal incontinence. Accessibility Unable to load your collection due to an error, Unable to load your delegates due to an error. This study will analyze the clinical effective rate, functional outcomes, quality of life, daily average number of fecal incontinence, and effective prescriptions of acupuncture for patients with fecal incontinence. The primary outcome measures will be clinical effective rate, functional outcomes, and quality of life. Last modified on July 15th, 2021. Hutson JM, Dughetti L, Stathopoulos L, Southwell BR. In doing so the ability to defer defaecation improves, resulting in a decrease in episodes of incontinence. government site. Article. In order to better prepare results for usage in guideline development, the quality of evidence for different outcomes will be graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Whitehead W.E., Wald A., Diamant N.E., Enck P., Pemberton J.H., Rao S.S. Functional disorders of the anus and rectum. [27] In the United States, the 4-year incidence of fecal incontinence among the community residents over 65 years old is 17%. Davila GW, Ghoniem GM, Wexner SD. Takahashi T. Mechanism of acupuncture on neuromodulation in the gut a review. The results of the study demonstrated that 76.7% of participants were cured, for 6.7% of patients the electroacupuncture treatment was effective, and for the rest of the patients, 16.6%, the treatment failed. Effect sizes with their 95% confidence intervals (95% CIs) will be extracted. 2019 Feb;98(7):e14482. Adequate anorectal sensation combined with pelvic floor muscle strength helps maintain fecal continence. Acupuncture is an old practice of Traditional Chinese Medicine that might be used to treat fecal incontinence. Materials and Methods: Cochrane Library, Web of Science, Embase, PubMed, and CENTRAL electronic databases were searched until August 2020. doi: 10.1097/MD.0000000000014482. The self-rating scores for satisfaction in the acupuncture-moxibustion group were superior. Two reviewers (Lin HX and Hu GJ) will independently screen the titles and abstracts of citations to delete irrelevant studies, and then examine the full-text reports, identify potential studies, and assess eligibility of studies for inclusion. Kantzides A., Owens N.C., De Matteo R., Badoer E. Right atrial stretch activates neurons in autonomic brain regions that project to the rostral ventrolateral medulla in the rat. Posterior tibial nerve stimulation for the treatment of fecal incontinence following obstetric anal sphincter injury, Three-year cost-effectiveness model for non-animal stabilized hyaluronic acid and dextranomer copolymer compared with sacral nerve stimulation after conservative therapy for the management of fecal incontinence, Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders, Systemic acupuncture in patients with faecal incontinence, Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence a randomized clinical trial, Sacral nerve stimulation versus percutaneous tibial nerve stimulation for faecal incontinence: a systematic review and meta-analysis, Copracrasia treated with acupuncture and moxibustion: a randomized controlled trial, Randomized Controlled Clinical Trial of Electroacupuncture for Fecal Incontinence, Prospective comparison of faecal incontinence grading systems, The Cochrane Collaboration. In addition, references were searched. Disagreements will be resolved by consensus or through discussion with a third review author (Chen YJ). Yan B, Jiang H, Cao J, Liu Y, Liu X, Ha L, Li T, Wang F, Liu C. Medicine (Baltimore). Percutaneous tibial nerve stimulation (PTNS) is a new treatment which can improve symptoms in patients who have faecal incontinence by stimulating the sacral nerves that regulate bladder and bowel function. Received 2019 Jan 17; Accepted 2019 Jan 21. In addition, improvement in fecal continence remained significantly improved after 18 months of follow-up. It is located on the inside of your leg, just above your ankle. Acupuncture needles were inserted at the BL33 points (bilateral), and the needles were manually stimulated for 10 minutes. FOIA Usually, thin needles are inserted into the skin and stimulated manually or electrically during the session. Patients with at least one-time urinary incontinence plus FI episode per day caused by cerebral or spinal injury. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Acupoints characteristics will be analyzed by Traditional Chinese Medicine inheritance support system. Percutaneous tibial nerve stimulation (PTNS) is considered to be a variation of the electroacupuncture technique because it uses an acupuncture needle and is derived from the ancient practice of acupuncture. Washabau R.J., Fudge M., Price W.J., Barone F.C. A.D. and A.S. wrote the first draft of the article and all authors critically reviewed subsequent drafts. [33,35] It is confirmed that acupuncture could relieve pain and regulate peripheral circulation, which is beneficial for bladder dysfunction and even gastrointestinal dysfunction. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: The fecal incontinence severity index. On the manovolumetric variables a limited increase of resting from 25 (17-35) mmHg to 36 (20-42) mmHg, (p=0.05) and sustained squeeze anal pressure, changing from 41 (32-68) mmHg to 60 (40-100) mmHg (p<0.05) were reported. [13] Compared with sham acupuncture, acupuncture at the lumbosacral region is effective for women suffering from stress urinary incontinence[14]; the similar but slightly different clinical outcomes can be seen in nerve stimulation,[15] which may also have an impact on functional outcomes or quality of life of patients with fecal incontinence. [22]. J Auton Nerv Syst. It is a longevity point that is useful in improving the overall health of the body so that you can live longer. [18] Participants with urinary and fecal incontinence will be excluded. Inclusion in an NLM database does not imply endorsement of, or agreement with, A.D. and A.S. conducted screening of articles and data extraction. Allam N., Mogahed H. Effect of laser acupuncture on fecal; incontinence after anorectal surgery. and transmitted securely. Stress urinary incontinence (SUI), the most common type of urinary incontinence, is defined as the involuntary loss of urine through physical exertion or effort, coughing or sneezing. Etiology and management of fecal incontinence. You can find out more about this by reading our information on acupuncture. If there are any contraindications (medical reasons that you should not try certain therapies), your healthcare provider will let you know. There will not be any restrictions on age and original countries of the participants. [29] At the same time, previous studies have confirmed that advancing age, pelvic floor dysfunction, parity, stool form disturbance, urinary incontinence, and multiple chronic diseases are potential pathophysiological mechanisms of fecal incontinence. Electroacupuncture is being studied and researched for chronic bowel and bladder problems. See this image and copyright information in PMC. All studies report significant improvements in continence, although they all apply different acupuncture regimens. Fecal diversion. FOIA The aim of this study was therefore to investigate if manual acupuncture might also affect fecal incontinence favorably. Otherwise, we will analyze the available information and conduct sensitivity analysis to explore the potential impact of insufficient information on the results of the meta-analysis. Acupuncture treatment was effective in heterogenic groups of patients as well as on homogenous groups of patients with anorectal surgery or a history of spinal or cerebral injury. [7,8] However, only 46% of patients who underwent surgery for prolapse reported continence improvement at 38.9 months of follow-up, while those who underwent an operative procedure other than ventral rectopexy were similar to nonoperated patients. Epub 2008 Feb 27. NOTE: Each form of incontinence treatment you have should be thoroughly discussed and tried under your physicians care. Patients with irregular bowel habits and/or loose stools reported significant improvement. This may be the first of some much needed information to help us all know more about the potential and positive effects of this alternative therapy. HHS Vulnerability Disclosure, Help 1. The incidence range is wide, and it is believed that the prevalence rate is underestimated, as less than 25% of patients report this complaint to their physicians, leaving a high number of cases undetected and unreported. doi: 10.1097/MD.0000000000010998. RCTs, observational studies, case series, and casecontrol studies will be included for data mining. A.D., A.S., T.A., and N.E.S. Available at: Quantifying heterogeneity in a meta-analysis, Associations of the serotonin transporter promoter polymorphism (5-HTTLPR) with bipolar disorder and treatment response: a systematic review and meta-analysis, Prog Neuropsychopharmacol Biol Psychiatry, Alpha lipoic acid combined with epalrestat: a therapeutic option for patients with diabetic peripheral neuropathy, GRADE guidelines: 14. The authors have no conflicts of interest to disclose. Fecal incontinence should be confirmed according to the 1999 consensus standard of the American Association of Colorectal Surgeons. Based on small, low-quality studies, it might be a safe, inexpensive, and efficient method. An expanding awareness of the unwanted side effects of pharmaceutical treatments has led to an increased use of acupuncture as a contemporary health care option. National Library of Medicine Acupuncture is an alternative medical treatment that involves inserting tiny needles into specific points on a person's body. Fecal incontinence treated with acupuncture: a pilot study, Effect of nifedipine on anorectal sensorimotor functions in health and fecal incontinence, Acupuncture-from empiricism to science-functional background to acupuncture effects in pain and disease, Effects of electroacupuncture combined with stem cell transplantation on anal sphincter injury-induced faecal incontinence in a rat model, http://creativecommons.org/licenses/by/4.0, https://community.cochrane.org/help/tools-and-software/revman-5, http://cdmd.cnki.com.cn/Article/CDMD-84502-1017234520.htm. [24] published a pilot study describing 15 females diagnosed with FI for a period longer than a year. They will assess the following domains: Randomization sequence generation, allocation concealment, blinding of outcome assessors, incomplete outcome data, selective outcome reporting, other sources of bias. The secondary outcomes will be daily average number of fecal incontinence, adverse events, and discontinuations due to adverse events. The number of days on which defecation occurred also increased significantly, from 2.0 (2.0, 2.5) to 2.5 (2.0, 3.5) days/week ( P < 0.001). To evaluate improvements in health-related . Epub 2008 Jan 19. Patients younger than 21 years of age; prior muscle injury caused by surgical episiotomy or accident, neurological disorders, metabolic diseases, cognitive deficits, or other factors that could influence the incontinence, such as chronic diarrhea. However, recently, we showed that acupuncture is an effective treatment modality for patients with long-term low anterior resection syndrome [11]. Patients with moderate FI after anorectal surgery. Jorge M.J.N., Wexner S.D. What is the impact of fecal incontinence on quality of life? The purpose of this study is to evaluate the effect of acupuncture on clinical effective rate, functional outcomes, quality of life, daily average number of fecal incontinence, adverse events, and discontinuations events in patients with fecal incontinence. All 18 patients included into this study had a FI diagnosis for at least 6 months and had impaired continence function confirmed by anorectal manometry; furthermore, they have not had any history of surgery, trauma, metabolic diseases, neurologic disorders, or cognitive deficits that could have caused the incontinence. Please enable it to take advantage of the complete set of features! Each patient was submitted to one acupuncture treatment per week for a ten-week period. The site is secure. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 5. The role of traditional acupuncture in low anterior resection syndrome treatment a pilot study. Rectal volume tolerability and anal pressures in patients with fecal incontinence treated with sacral nerve stimulation. Accessibility United European Gastroenterol J. FOIA The authors discussed that acupuncture techniques might improve the pathological brain activity related to the bowel motility through the modulation of the homeostatic afferent processing network. Acupuncture is an old practice of Traditional Chinese Medicine that might be used to treat fecal incontinence. Acupuncture treatment results are also evaluated with the use of anorectal manometry; however, sensory threshold, sphincter tone, and sustained squeeze pressure do not greatly reflect a good clinical improvement, as the anal contraction results return to the pre-treatment levels even though the incontinence scores remain significantly improved [24]. Lin Y., Zhou Z., Shen W. Clinical and experimental studies on shallow needling technique for treating childhood diarrhea. 1. [15] published a pilot study describing electroacupuncture application in 30 patients with cerebral or spinal injury, who experienced at least one period per day of urinary plus fecal incontinence episodes. When applied to spinally injured patients suffering with urge and stress incontinence, acupuncture reduced reflex bladder activity, providing a scientific foundation to clinical treatment and point selection for the treatment of urinary urge and stress incontinence. Dis Colon Rectum. National Library of Medicine An electronic search will be conducted. the tibial nerve, which runs from the lower spine to the ankle, is an acupuncture point to reduce . Values in anorectal manometry and FISI improved statistically significantly in the experimental group in comparison to the control group (p > 0.001) [23]. [10] in the pilot study reports statistically significant improvements in VAS scores assessing fecal incontinence symptoms (p < 0.0001) and general FIQL value (p < 0.05), where domains of embarrassment and life style changed the most after 10 weekly traditional acupuncture sessions and 61% of patients reported improved quality of life in every assessed domain. Over time, acupuncture has evolved along with technology, and nowadays, might be used in the combination with ultrasound, laser, infrared radiation and other means in order to achieve better results, although the efficacy of this method is very little investigated and scientific evidence is scarce. Participants in the intervention group are those undergoing acupuncture, including electroacupuncture therapy, acupuncture alone, laser acupuncture, and warm acupuncture. If you are interested in trying acupuncture, discuss it with your healthcare provider and only seek a certified or licensed acupuncturist after your providers approval to proceed. Before treatment and at regular intervals after acupuncture sessions the defects of anal continence were assessed. Disclaimer. Urinary incontinence is a common condition with aging, especially among women who have had children. FOIA Yan Cui. HHS Vulnerability Disclosure, Help Clipboard, Search History, and several other advanced features are temporarily unavailable.
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