unctional Anorectal Disorders DIL

i T his report defines criteria for diagnosing functional anoectal disorders (ie, fecal incontinence, anorectal pain, nd disorders of defecation). Functional fecal incontience is defined as the uncontrolled passage of fecal aterial recurring for >3 months in an individual with a evelopmental age of >4 years that is associated with: 1) abnormal functioning of normally innervated and tructurally intact muscles, and/or (2) no or minor abormalities of sphincter structure and/or innervation nsufficient to explain fecal incontinence, and/or (3) ormal or disordered bowel habits (ie, fecal retention or iarrhea), and/or (4) psychological causes. However, onditions wherein structural and/or neurogenic abnoralities explain the symptom, or are part of a generalzed process (eg, diabetic neuropathy) are not included ithin functional fecal incontinence. Functional fecal ncontinence is a common, but underrecognized sympom, which is equally prevalent in men and women, and an often cause considerable distress. The clinical feaures are useful for guiding diagnostic testing and therpy. Functional anorectal pain syndromes include procalgia fugax (fleeting pain) and chronic proctalgia; hronic proctalgia may be subdivided into levator ani yndrome and unspecified anorectal pain, which are efined by arbitrary clinical criteria. Functional defecaion disorders are characterized by 2 or more symptoms f constipation, with >2 of the following features during efecation: impaired evacuation, inappropriate contracion of the pelvic floor muscles, and inadequate propulive forces. Functional disorders of defecation may be menable to pelvic floor retraining by biofeedback therpy (such as dyssynergic defecation).