#RISK FACTORS FOR OVERFLOW INCONTINENCE MANUAL#

#RISK FACTORS FOR OVERFLOW INCONTINENCE MANUAL#

Fecal impaction may be treated with polyethylene glycol, enemas, or manual disimpaction. Simple anorectal fistulas can be treated conservatively with sitz baths and analgesics, whereas complex or nonhealing fistulas may require surgery.

Anorectal condylomas, or anogenital warts, are treated based on size and location, with office treatment consisting of topical trichloroacetic acid or podophyllin, cryotherapy, or laser treatment. For the treatment of grade III internal hemorrhoids, surgical hemorrhoidectomy has higher remission rates but increased pain and complication rates compared with rubber band ligation. Grades I through III internal hemorrhoids can be managed with rubber band ligation. Thrombosed hemorrhoids are best treated with hemorrhoidectomy if symptoms are present for less than 72 hours. Symptomatic external hemorrhoids are managed with dietary modifications, topical steroids, and analgesics. Effective treatments for anal fissures include onabotulinumtoxinA, topical nitroglycerin, and topical calcium channel blockers. Pruritus ani, or perianal itching, is managed by treating the underlying cause, ensuring proper hygiene, and providing symptomatic relief with oral antihistamines, topical steroids, or topical capsaicin. Patients with red flags such as increased age, family history, persistent anorectal bleeding despite treatment, weight loss, or iron deficiency anemia should undergo colonoscopy. In addition to recognizing common benign anorectal disorders, physicians must maintain a high index of suspicion for inflammatory and malignant disorders. The prevalence of benign anorectal conditions in the primary care setting is high, although evidence of effective therapy is often lacking.

Risk factors for overflow incontinence