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National Collaborating Centre for Acute Care (UK). Faecal Incontinence: The Management of Faecal Incontinence in Adults. London: National Collaborating Centre for Acute Care (UK); 2007. (NICE Clinical Guidelines, No. 49.)

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Faecal Incontinence: The Management of Faecal Incontinence in Adults.

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APPENDIX BCLINICAL QUESTIONS

Good practice in managing faecal incontinence

1.

Do any educational interventions improve outcomes for patients with faecal incontinence?

Baseline assessment and initial management

2.

What does a structured assessment add to the assessment of patients with faecal incontinence?

3.

What does clinician examination add to the assessment of the patient with faecal incontinence?

4.

What does patient reporting add to the assessment of the patient with faecal incontinence?

5.

What is the effectiveness of modifying diet or fluid intake at managing faecal incontinence?

6.

What is the effectiveness of modifying drug administration at managing faecal incontinence?

7.

What is the effectiveness of any combination of dietary, fluid or drug administration in managing faecal incontinence?

8.

What are the most effective products (absorbent products, containment products and plugs) to manage faecal incontinence?

9.

What are the most effective skin care products to manage faecal incontinence?

10.

What is the best practice goal setting (including involving patients) for satisfactory treatment of faecal incontinence?

Specialised management

11.

What is the effectiveness of pelvic floor/anal sphincter exercises vs all other conservative therapies?

12.

What is the effectiveness of biofeedback vs all other conservative therapies?

13.

Which modality of biofeedback is most effective at managing faecal incontinence?

14.

What is the effectiveness of external electrical stimulation to manage faecal incontinence?

Specialist assessment

15.

What does functional testing add to the assessment of the patient with faecal incontinence?

16.

What do imaging techniques add to the assessment of patients with faecal incontinence?

17.

What does endoscopy add to the assessment of patients with faecal incontinence?

18.

Are any investigation techniques better than others?

19.

Which combinations of tests effectively select patients for specific treatment strategies?

Surgical Interventions in all patient groups

20.

Is surgery effective and does it last compared with no surgery (conservative treatment)?

21.

Are any surgical interventions more effective than others?

22.

Do any interventions, pre or post surgery, affect the outcome of surgery for faecal incontinence?

Specific patient groups

23.

What procedures are effective in patients or residents in care homes with faecal incontinence related to faecal loading, impaction or constipation?

24.

What procedures are effective in patients with limited mobility and faecal incontinence?

25.

In patients who report FI who are using enteral nutritional support, what is the effect of lactose free nutritional intervention vs nutritional intervention containing lactose on patient related outcomes?

26.

In patients who report FI using antibiotics, what is the effect of probiotics vs no probiotics on patient related outcomes?

Copyright © 2007, National Collaborating Centre for Acute Care.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of National Collaborating Centre for Acute Care to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

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