Anale incontinentie [evidence statement]

B.1 Anamnese

  • De fysiotherapeut neemt een intake af om na te gaan of er bekkenfysiotherapie is geïndiceerd.
  • De intake richt zich op stoornissen in functies en anatomische eigenschappen, beperkingen in activiteiten/vaardigheden en participatie en de invloed van (belemmerende of bevorderende) externe en persoonlijke factoren. Op grond van deskundigenoordeel, een systematisch literatuuronderzoek51 en consensus binnen de werkgroep (zie het stroomdiagram) worden de volgende onderwerpen bij de intake relevant geacht:
    • contactreden en hulpvraag van de patiënt;
    • de aard (onderliggende oorzaak/gesteldheid/eigenschap/hoedanigheid) en ernst van AI (op basis van ICF-domeinen);
    • mate van beïnvloedbaarheid (belemmerende factoren algemeen en lokaal);
    • rode vlaggen;
    • proctologische, gynaecologische, obstetrische, urologische en seksuologische voorgeschiedenis in relatie tot het bewegingsapparaat;
    • comorbiditeit;
    • copingstrategieën;
    • psychosociale klachten;
    • defecatie- en mictiepatroon;
    • voeding- en vloeistofinname;
    • status van de continentiecomponenten (spierfunctie, reservoirfunctie, consistentie feces, (h)erkenning gezondheidsprobleem en de interactie daartussen);
    • verwachtingspatroon van de patiënt.
  • Het geven van voorlichting, inzicht en advies kan zijn verweven in de anamnese.
  • 1. Wees PJ van der, Hendriks HJM, Heldoorn M, Custers JW, Bie RA de. Methode voor ontwikkeling, implementatie en bijstelling van KNGF-richtlijnen. Methode versie 2.5. Amersfoort /Maastricht: KNGF; 2007.
    2. CBO Kwaliteitsinstituut voor de Gezondheidszorg. Evidence-based Richtlijnontwikkeling. Handleiding voor werkgroepleden. Utrecht: CBO; 2007.
    3. Landefeld CS, Bowers BJ, Feld AD, Hartmann KE, Hoffman E, Ingber MJ, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008;148(6):449-58.
    4. Haylen BT, Ridder D de, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct. 2009;21(1):5-26.
    5. Whitehead WE. Diagnosing and managing fecal incontinence: if you don't ask, they won't tell. Gastroenterology. 2005;129(1):6.
    6. Kalantar JS, Howell S, Talley NJ. Prevalence of faecal incontinence and associated risk factors; an underdiagnosed problem in the Australian community? Med J Aust. 2002;176(2):54-7.
    7. Macmillan AK, Merrie AE, Marshall RJ, Parry BR. The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum. 2004;47(8):1341-9.
    8. Pretlove SJ, Radley S, Toozs-Hobson PM, Thompson PJ, Coomarasamy A, Khan KSCP. Prevalence of anal incontinence according to age and gender: a systematic review and meta-regression analysis. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(4):407-17.
    9. Teunissen TA, Bosch WJ van den, Hoogen HJ van den, Lagro-Janssen AL. Prevalence of urinary, fecal and double incontinence in the elderly living at home. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(1):10-3; discussion 3.
    10. Chassagne P, Landrin I, Neveu C, Czernichow P, Bouaniche M, Doucet J, et al. Fecal incontinence in the institutionalized elderly: incidence, risk factors, and prognosis. Am J Med. 1999;106(2):185-90.
    11. Thomas TM, Egan M, Walgrove A, Meade TW. The prevalence of faecal and double incontinence. Community Med. 1984;6(3):216-20.
    12. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Prevalence of double incontinence, risks and influence on quality of life in a general female population. Neurourol Urodyn. 2010;29(4):545-50.
    13. Madoff RD, Parker SC, Varma MG, Lowry ACCM. Faecal incontinence in adults. Lancet. 2004;364(9434):621-32.
    14. Tjandra JJ, Dykes SL, Kumar RR, Ellis CN, Gregorcyk SG, Hyman NH, et al. Practice parameters for the treatment of fecal incontinence. Dis Colon Rectum. 2007;50(10):1497-507.
    15. Farage MA, Miller KW, Berardesca E, Maibach HI. Psychosocial and societal burden of incontinence in the aged population: a review. Arch Gynecol Obstet. 2008;277(4):285-90.
    16. Markland AD, Goode PS, Burgio KL, Redden DT, Richter HE, Sawyer P, et al. Incidence and risk factors for fecal incontinence in black and white older adults: a population-based study. J Am Geriatr Soc. 2010;58(7):1341-6.
    17. Rey E, Choung RS, Schleck CD, Zinsmeister AR, Locke GR, 3rd, Talley NJ. Onset and risk factors for fecal incontinence in a US community. Am J Gastroenterol. 2010;105(2):412-9.
    18. Ostbye T, Seim A, Krause KM, Feightner J, Hachinski V, Sykes E, et al. A 10-year follow-up of urinary and fecal incontinence among the oldest old in the community: the Canadian Study of Health and Aging. Can J Aging. 2004;23(4):319-31.
    19. Deutekom M, Dobben AC, Dijkgraaf MG, Terra MP, Stoker J, Bossuyt PM. Costs of outpatients with fecal incontinence. Scand J Gastroenterol. 2005 May;40(5):552-8.
    20. Xu X, Menees SB, Zochowski MK, Fenner DE. Economic cost of fecal incontinence. Dis Colon Rectum. 2012;55(5):586-98.
    21. Dunivan GC, Heymen S, Palsson OS, von Korff M, Turner MJ, Melville JL, et al. Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol. 2010;202(5):493 e1-6.
    22. College voor Zorgverzekeringen. GIPeilingen 2011: Ontwikkelingen genees- en hulpmiddelengebruik 2012; nr. 33. Diemen: CVZ; 2012.
    23. Bols EM, Hendriks EJ, Berghmans BC, Baeten CG, Nijhuis JG, Bie RA de. A systematic review of etiological factors for postpartum fecal incontinence. Acta Obstet Gynecol Scand. 2010;89(3):302-14.
    24. Brown SJ, Gartland D, Donath S, MacArthur C. Fecal incontinence during the first 12 months postpartum: complex causal pathways and implications for clinical practice. Obstet Gynecol. 2012;119(2 Pt 1):240-9.
    25. Solans-Domenech M, Sanchez E, Espuna-Pons M. Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors. Obstet Gynecol. 2010;115(3):618-28.
    26. Torrisi G, Minini G, Bernasconi F, Perrone A, Trezza G, Guardabasso V, et al. A prospective study of pelvic floor dysfunctions related to delivery. Eur J Obstet Gynecol Reprod Biol. 2012;160(1):110-5.
    27. Pretlove SJ, Thompson PJ, Toozs-Hobson PM, Radley S, Khan KS. Does the mode of delivery predispose women to anal incontinence in the first year postpartum? A comparative systematic review. BJOG. 2008;115(4):421-34.
    28. Nelson RL, Furner SE, Westercamp M, Farquhar C. Cesarean delivery for the prevention of anal incontinence. Cochrane Database Syst Rev. 2010(2):CD006756.
    29. Nelson RL, Westercamp M, Furner SECN. A systematic review of the efficacy of cesarean section in the preservation of anal continence. Dis Colon Rectum. 2006;49(10):1587-95.
    30. Altman D, Zetterstrom J, Lopez A, Pollack J, Nordenstam J, Mellgren A. Effect of hysterectomy on bowel function. Dis Colon Rectum. 2004;47(4):502-8; discussion 8-9.
    31. Forsgren C, Zetterstrom J, Lopez A, Nordenstam J, Anzen B, Altman D. Effects of hysterectomy on bowel function: a three-year, prospective cohort study. Dis Colon Rectum. 2007;50(8):1139-45.
    32. Geinitz H, Thamm R, Keller M, Astner ST, Heinrich C, Scholz C, et al. Longitudinal study of intestinal symptoms and fecal continence in patients with conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2011;79(5):1373-80.
    33. Little DJ, Kuban DA, Levy LB, Zagars GK, Pollack A. Quality-of-life questionnaire results 2 and 3 years after radiotherapy for prostate cancer in a randomized dose-escalation study. Urology. 2003;62(4):707-13.
    34. Nelson RL, Furner SE. Risk factors for the development of fecal and urinary incontinence in Wisconsin nursing home residents. Maturitas. 2005;52(1):26-31.
    35. Byrne CM, Solomon MJ, Young JM, Rex J, Merlino CL. Biofeedback for fecal incontinence: short-term outcomes of 513 consecutive patients and predictors of successful treatment. Dis Colon Rectum. 2007;50(4):417-27.
    36. Bo K, Aschehoug A. Strength training. In: Bo K, Berghmans B, Morkved S, Kampen M van, editors. Evidence-based physical therapy for the pelvic floor. London: Elsevier Ltd; 2007. p. 119-32.
    37. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-59.
    38. Norton C, Cody JD. Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Cochrane Database Syst Rev. 2012;7:CD002111.
    39. NICE Clinical Guideline no. 49. The management of faecal incontinence in adults. Londen: National Collaborating Centre for Acute Care; 2007.
    40. Jorge JM, Habr-Gama A, Wexner SDCJ. Biofeedback therapy in the colon and rectal practice. Appl Psychophysiol Biofeedback. 2003;28(1):47-61.
    41. Osterberg A, Graf W, Eeg-Olofsson K, Hallden M, Pahlman L. Is electrostimulation of the pelvic floor an effective treatment for neurogenic faecal incontinence? Scand J Gastroenterol. 1999;34(3):319-24.
    42. Bols E, Hendriks E, Bie R de, Baeten C, Berghmans B. Predictors of a favorable outcome of physiotherapy in fecal incontinence: secondary analysis of a randomized trial. Neurourol Urodyn. 2012 Sep;31(7):1156-60. doi: 10.1002/nau.21236. Epub 2012 Apr 4.
    43. Ryn A-K, Morren GI, Hallbook O, Sjodahl R. Long-term results of electromyographic biofeedback training for faecal incontinence. Dis Colon Rectum. 2000;43:1262-6.
    44. Terra MP, Deutekom M, Dobben AC, Baeten CG, Janssen LW, Boeckxstaens GE, et al. Can the outcome of pelvic-floor rehabilitation in patients with fecal incontinence be predicted? Int J Colorectal Dis. 2008;23(5):503-11.
    45. Cheetham M, Brazzelli M, Norton C, Glazener CM. Drug treatment for faecal incontinence in adults. Cochrane Database Syst Rev. 2009(1).
    46. Markland AD, Richter HE, Burgio KL, Myers DL, Hernandez AL, Subak LLC. Weight loss improves fecal incontinence severity in overweight and obese women with urinary incontinence. Int Urogynecol J. 2011;22(9):1151-7.
    47. Norton C, Whitehead WE, Bliss DZ, Harari D, Lang J. Management of fecal incontinence in adults. Neurourol Urodyn. 2010;29(1):199-206.
    48. Norton C, Whitehead WE, Bliss DZ, Harari D, Lang J. Conservative and pharmacological management of faecal incontinence in adults. In: Abrams P, Cardoza L, Khoury S, Wein A, editors. Incontinence. Plymouth UK: Health Publications Ltd; 2009. p. 1321-86.
    49. Bliss DZ, Jung HJ, Savik K, Lowry A, LeMoine M, Jensen L, et al. Supplementation with dietary fiber improves fecal incontinence. Nurs Res. 2001;50(4):203-13.
    50. Stafne S, Salvesen K, Romundstad P, Torjusen I, Morkved S. Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomised controlled trial. Bjog. 2012;119(10):1270-80.
    51. Fallon A, Westaway J, Moloney C. A systematic review of psychometric evidence and expert opinion regarding the assessment of faecal incontinence in older community-dwelling adults. Int J Evid Based Healthc. 2008;6(2):225-59.
    52. Baxter NN, Rothenberger DA, Lowry ACCB. Measuring fecal incontinence. Dis Colon Rectum. 2003;46(12):1591-605.
    53. Avery KN, Bosch JL, Gotoh M, Naughton M, Jackson S, Radley SC, et al. Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol. 2007;177(1):39-49.
    54. Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10(4):407-15.
    55. Veldhuyzen van Zanten SJ, Talley NJ, Bytzer P, Klein KB, Whorwell PJ, Zinsmeister ARC. Design of treatment trials for functional gastrointestinal disorders. Gut. 1999;45 Suppl 2:II69-77.
    56. Backer JCS de. Bekkenbodemreëducatie bij anale problematiek. In: Smits-Engelsman BCM, Ham I van, Vaes P, Aufdemkampe G, Dekker JB den, redactie. Jaarboek Fysiotherapie/kinesitherapie. Houten/Diegem: Bohn Stafleu van Loghum; 1998. p. 16-37.
    57. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32(9):920-4.
    58. Hosker G, Cody JD, Norton CC. Electrical stimulation for faecal incontinence in adults. Cochrane Database Syst Rev. 2007(3):CD001310.
    59. Bols E, Berghmans B, Bie R de, Govaert B, Wunnik B van, Heymans M, et al. Rectal balloon training as add-on therapy to pelvic floor muscle training in adults with fecal incontinence: a randomized controlled trial. Neurourol Urodyn. 2012;31(1):132-8.
    60. Heymen S, Scarlett Y, Jones K, Ringel Y, Drossman D, Whitehead WE. Randomized controlled trial shows biofeedback to be superior to pelvic floor exercises for fecal incontinence. Dis Colon Rectum. 2009;52(10):1730-7.
    61. Heerkens Y, Hendriks EJ, Oostendorp RA. Assessment instruments and the ICF in rehabilitation and physiotherapy. Medical Rehabilitation. 2006;10(3):1-14.
    62. Koninklijk Nederlands Genootschap voor Fysiotherapie. Brochure Zorgvuldig handelen bij voorbehouden en bijzondere handelingen. Amersfoort: KNGF; 2010.
    63. NVFB. Engelenburg-van Lonkhuyzen M van, Hogen Esch F, Westerik-Verschuuren L, Coppoolse R. Beroepscompetentieprofiel Bekkenfysiotherapeut. Amersfoort: NVFB; 2009.
    64. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213-40.
    65. Chiarioni G, Bassotti G, Monsignori A, Menegotti M, Salandini L, Di Matteo G, et al. Anorectal dysfunction in constipated women with anorexia nervosa. Mayo Clin Proc. 2000;75(10):1015-9.
    66. Bols EMJ, Berghmans LCM, Hendriks HJM, Baeten CGMI, Bie RA de. Physiotherapy and surgery in fecal incontinence: an overview. Physical Therapy Reviews. 2008;13(2):1-20.
    67. Shamliyan TA, Bliss DZ, Du J, Ping R, Wilt TJ, Kane RL. Prevalence and risk factors of fecal incontinence in community-dwelling men. Rev Gastroenterol Disord. 2009;9(4):E97-110.
    68. Oberwalder M, Connor J, Wexner SDCO. Meta-analysis to determine the incidence of obstetric anal sphincter damage. Br J Surg. 2003;90(11):1333-7.
    69. Chiarioni G, Bassotti G, Stanganini S, Vantini I, Whitehead WECC. Sensory retraining is key to biofeedback therapy for formed stool fecal incontinence. Am J Gastroenterol. 2002;97(1):109-17.
    70. Glia A, Gylin M, Akerlund JE, Lindfors U, Lindberg G. Biofeedback training in patients with fecal incontinence. Dis Colon Rectum. 1998;41:359-64.
    71. Sangwan YP, Coller JA, Schoetz DJ, Jr., Murray JJ, Roberts PLCS. Latency measurement of rectoanal reflexes. Dis Colon Rectum. 1995;38(12):1281-5.
    72. Kraemer M, Ho YH, Tan W. Effectiveness of anorectal biofeedback therapy for faecal incontinence: medium-term results. Tech Coloproctol. 2001;5(3):125-9.
    73. Leroi AM, Dorival MP, Lecouturier MG. Pudendal neuropathy and severity of incontinence but not presence of an anal sphincter defect may determine the response to biofeedback therapy in fecal incontinence. Dis Colon Rectum. 1999;42:762-9.
    74. Norton C, Chelvanayagam S, Wilson-Barnett J, Redfern S, Kamm MACN. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology. 2003;125(5):1320-9.
    75. Pager CK, Solomon MJ, Rex J, Roberts RACP. Long-term outcomes of pelvic floor exercise and biofeedback treatment for patients with fecal incontinence. Dis Colon Rectum. 2002;45(8):997-1003.
    76. Rieger NA, Wattchow DA, Sarre RG, Cooper SJ, Rich CA, Saccone GT, et al. Prospective trial of pelvic floor retraining in patients with fecal incontinence. Dis Colon Rectum. 1997;40(7):821-6.
    77. Boselli AS, Pinna F, Cecchini S, Costi R, Marchesi F, Violi V, et al. Biofeedback therapy plus anal electrostimulation for fecal incontinence: prognostic factors and effects on anorectal physiology. World J Surg. 2010;34(4):815-21.
    78. Fynes MM, Marshall K, Cassidy M, Behan M, Walsh D, O'Connell PR, et al. A prospective, randomized study comparing the effect of augmented biofeedback with sensory biofeedback alone on fecal incontinence after obstetric trauma. Dis Colon Rectum. 1999;42(6):753-8; discussion 8-61.
    79. Abrams P, Cardoza L, Khoury S, Wein A, editors. Incontinence: 4th International Consultation on Incontinence. Paris, France: Health Publication Ltd; 2009.
    80. Sievert KD, Amend B, Toomey PA, Robinson D, Milsom I, Koelbl H, et al. Can we prevent incontinence? ICI-RS 2011. Neurourol Urodyn. 2012;31(3):390-9.
    81. Schnelle JF, Leung FW, Rao SS, Beuscher L, Keeler E, Clift JW, et al. A controlled trial of an intervention to improve urinary and fecal incontinence and constipation. J Am Geriatr Soc. 2010;58(8):1504-11.
    82. Schnelle JF, Alessi CA, Simmons SF, Al-Samarrai NR, Beck JC, Ouslander JG. Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents. J Am Geriatr Soc. 2002;50(9):1476-83.
    83. Erekson EA, Sung VW, Myers DL. Effect of body mass index on the risk of anal incontinence and defecatory dysfunction in women. Am J Obstet Gynecol. 2008;198(5):596 e1-4.
    84. Altman D, Falconer C, Rossner S, Melin I. The risk of anal incontinence in obese women. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(11):1283-9.
    85. Burgio KL, Richter HE, Clements RH, Redden DT, Goode PS. Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol. 2007;110(5):1034-40.
    86. Roberson EN, Gould JC, Bushman WA. Prevalence of fecal incontinence and urinary incontinence after bariatric surgery (abstract). Gastroenterology. 2008;134:A65.
    87. Markland AD, Richter HE, Burgio KL, Bragg C, Hernandez AL, Subak LLCMC. Fecal incontinence in obese women with urinary incontinence: prevalence and role of dietary fiber intake. Am J Obstet Gynecol. 2009;200(5):566 e1-6.
    88. Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481-90.
    89. Lauti M, Scott D, Thompson-Fawcett MW. Fibre supplementation in addition to loperamide for faecal incontinence in adults: a randomized trial. Colorectal Dis. 2008;10(6):553-62.
    90. Boyle R, Hay-Smith EJ, Cody JD, Morkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471.
    91. Bo K, Haakstad LA. Is pelvic floor muscle training effective when taught in a general fitness class in pregnancy? A randomised controlled trial. Physiotherapy. 2011;97(3):190-5.
    92. Wilson PD, Herbison GP. A randomized controlled trial of pelvic floor muscle exercises to treat postnatal urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(5):257-64.
    93. Glazener C, Herbison G, Wilson P, MacArthur C, Lang G, Gee H, et al. Conservative management of persistent postnatal urinary and faecal incontinence: randomised controlled trial. BMJ (Clinical research ed.) 2001;323(7313):593-6.
    94. Glazener CM, Herbison GP, MacArthur C, Grant A, Wilson PDCG. Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: six year follow up. BMJ. 2005;330(7487):337.
    95. Sleep J, Grant A. Pelvic floor exercises in postnatal care. Midwifery. 1987;3(4):158-64.
    96. Meyer S, Hohlfeld P, Achtari C, De Grandi P. Pelvic floor education after vaginal delivery. Obstet Gynecol. 2001;97(5 Pt 1):673-7.
    97. Dannecker C. The effect of the pelvic floor training device Epi-No on the maternal pelvic floor function six months after childbirth - follow-up study of a randomised controlled trial. Geburtshilfe Frauenheilkd. 2004;64(11):1192-8.
    98. Rockwood THCR. Incontinence severity and QOL scales for fecal incontinence. Gastroenterology. 2004;126(1 Suppl 1):S106-13.
    99. Vaizey CJ, Carapeti E, Cahill JA, Kamm MACV. Prospective comparison of faecal incontinence grading systems. Gut. 1999;44(1):77-80.
    100. Jorge JM, Wexner SDCJ. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36(1):77-97.
    101. Bols EM, Hendriks EJ, Deutekom M, Berghmans BC, Baeten CG, de Bie RACB. Inconclusive psychometric properties of the Vaizey score in fecally incontinent patients: a prospective cohort study. Neurourol Urodyn. 2010;29(3):370-7.
    102. Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum. 1999;42(12):1525-32.
    103. Pescatori M, Anastasio G, Bottini C, Mentasti A. New grading and scoring for anal incontinence. Evaluation of 335 patients. Dis Colon Rectum. 1992;35(5):482-7.
    104. Miller R, Bartolo DC, Locke-Edmunds JC, Mortensen NJCM. Prospective study of conservative and operative treatment for faecal incontinence. Br J Surg. 1988;75(2):101-5.
    105. Shelton AA, Madoff RD. Defining anal incontinence: establishing a uniform continence scale. Semin Colon Rectal Surg. 1997;8(2):54-60.
    106. Lunniss PJ, Kamm MA, Phillips RK. Factors affecting continence after surgery for anal fistula. Br J Surg. 1994;81(9):1382-5.
    107. Staskin D, Kelleher C, Avery K, Bosch R, Cotterill N, Coyne K, et al. Patient-reported outcome assessment. In: Abrams P, Cardoza L, Khoury S, Wein A, editors. Incontinence, 4th International Consultation on Incontinence: Health Publication Ltd; 2009. p. 363-412.
    108. Bols EM, Hendriks HJ, Berghmans LC, Baeten CG, Bie RA de. Responsiveness and interpretability of incontinence severity scores and FIQL scale in patients with fecal incontinence: a secondary analysis from a randomized controlled trial. Int Urogyn J 2013 Mar;24(3):469-78.
    109. Thomas S, Nay R, Moore K, Fonda D, Hawthorne G, Marosszeky N, et al. Continence Outcomes Measurement Suite Project (Final report). Australian Government Department of Health and Ageing; 2006.
    110. Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, et al. Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum. 2000;43(1):9-16; discussion 7.
    111. Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM, Schmulling C, Neugebauer E, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg. 1995;82(2):216-22.
    112. Hanneman MJ, Sprangers MA, Mik EL de, Ernest van Heurn LW, Langen ZJ de, Looyaard N, et al. Quality of life in patients with anorectal malformation or Hirschsprung’s disease: development of a disease-specific questionnaire. Dis Colon Rectum. 2001;44(11):1650-60.
    113. Bug GJ, Kiff ES, Hosker GCB. A new condition-specific health-related quality of life questionnaire for the assessment of women with anal incontinence. BJOG. 2001;108(10):1057-67.
    114. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams PCA. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322-30.
    115. Naliboff BDCN. Choosing outcome variables: global assessment and diaries. Gastroenterology. 2004;126(1 Suppl 1):S129-34.
    116. Irvine EJ, Whitehead WE, Chey WD, Matsueda K, Shaw M, Talley NJ, et al. Design of treatment trials for functional gastrointestinal disorders. Gastroenterology. 2006;130(5):1538-51.
    117. Fisher K, Bliss DZ, Savik K. Comparison of recall and daily self-report of fecal incontinence severity. J Wound Ostomy Continence Nurs. 2008;35(5):515-20.
    118. Bharucha AE, Seide BM, Zinsmeister AR, Melton LJ, 3rd. Insights into normal and disordered bowel habits from bowel diaries. Am J Gastroenterol. 2008;103(3):692-8.
    119. Stone AA, Shiffman S, Schwartz JE, Broderick JE, Hufford MR. Patient non-compliance with paper diaries. BMJ. 2002;324(7347):1193-4.
    120. Riegler G, Esposito I. Bristol scale stool form. A still valid help in medical practice and clinical research. Tech Coloproctol. 2001;5(3):163-4.
    121. Talley NJ, Nyren O, Drossman DA, Heaton KW, Veldhuyzen van Zanten SJO, Koch MM. The irritable bowel syndrome: towards optimal design of controlled treatment trials. Gastroenterol Int. 1994;6:189-211.
    122. Rogers RG, Abed H, Fenner DECR. Current diagnosis and treatment algorithms for anal incontinence. BJU Int. 2006;98 Suppl 1:97-106; discussion 7-9.
    123. Nederlandse Vereniging voor Fysiotherapie bij Bekkenproblematiek en pré- en postpartum gezondheidszorg (NVFB). Richtlijn voor het hygiënisch werken in het bekkenbodemgebied. Amersfoort: NVFB; 2005.
    124. Hansen JL, Bliss DZ, Peden-McAlpine C. Diet strategies used by women to manage fecal incontinence. J Wound Ostomy Continence Nurs. 2006;33(1):52-61; discussion 2.
    125. Burgt MLA van der, Verhulst FJCM. Doen en blijven doen, voorlichting en compliancebevordering door paramedici. Houten: Bohn Stafleu van Loghum; 2009.
    126. Osterberg A, Edebol Eeg-Olofsson K, Hallden M, Graf W. Randomized clinical trial comparing conservative and surgical treatment of neurogenic faecal incontinence. Br J Surg. 2004;91(9):1131-7.
    127. Naimy N, Lindam AT, Bakka A, Faerden AE, Wiik P, Carlsen E, et al. Biofeedback vs. electrostimulation in the treatment of postdelivery anal incontinence: a randomized, clinical trial. Dis Colon Rectum. 2007;50:2040-6.
    128. Mahony RT, Malone PA, Nalty J, Behan M, O’Connell P R, O’Herlihy CCM. Randomized clinical trial of intra-anal electromyographic biofeedback physiotherapy with intra-anal electromyographic biofeedback augmented with electrical stimulation of the anal sphincter in the early treatment of postpartum fecal incontinence. Am J Obstet Gynecol. 2004;191(3):885-90.
    129. Schwandner T, Konig IR, Heimerl T, Kierer W, Roblick M, Bouchard R, et al. Triple target treatment (3T) is more effective than biofeedback alone for anal incontinence: the 3T-AI study. Dis Colon Rectum. 2010;53(7):1007-16.
    130. Norton C, Gibbs A, Kamm MA. Randomized, controlled trial of anal electrical stimulation for fecal incontinence. Dis Colon Rectum. 2006;49(2):190-6.
    131. Sprakel B, Maurer S, Langer M, Diller R, Spiegel HU, Winde GCS. [Value of electrotherapy within the scope of conservative treatment of anorectal incontinence]. Zentralbl Chir. 1998;123(3):224-9.
    132. Bartlett L, Sloots K, Nowak M, Ho YH. Biofeedback for fecal incontinence: a randomized study comparing exercise regimens. Dis Colon Rectum. 2011;54(7):846-56.
    133. Healy CF, Brannigan AE, Connolly EM, Eng M, O’Sullivan M J, McNamara DA, et al. The effects of low-frequency endo-anal electrical stimulation on faecal incontinence: a prospective study. Int J Colorectal Dis. 2006;21(8):802-6.
    134. Davis KJ, Kumar D, Poloniecki J. Adjuvant biofeedback following anal sphincter repair: a randomized study. Aliment Pharmacol Ther. 2004;20(5):539-49.
    135. Ilnyckyj A, Fachnie E, Tougas GCI. A randomized-controlled trial comparing an educational intervention alone vs education and biofeedback in the management of faecal incontinence in women. Neurogastroenterol Motil. 2005;17(1):58-63.
    136. Solomon MJ, Pager CK, Rex J, Roberts R, Manning JCS. Randomized, controlled trial of biofeedback with anal manometry, transanal ultrasound, or pelvic floor retraining with digital guidance alone in the treatment of mild to moderate fecal incontinence. Dis Colon Rectum. 2003;46(6):703-10.
    137. Heymen S, Pikarsky A, Weiss E, Vickers D, Nogueras J, Wexner S. A prospective randomized trial comparing four biofeedback techniques for patients with fecal incontinence. Colorectal Dis. 2000;2:88-92.
    138. Miner PB, Donnelly TC, Read NWCM. Investigation of mode of action of biofeedback in treatment of fecal incontinence. Dig Dis Sci. 1990;35(10):1291-8.
    139. Norton C, Kamm MACN. Anal sphincter biofeedback and pelvic floor exercises for faecal incontinence in adults - a systematic review. Aliment Pharmacol Ther. 2001;15(8):1147-54.