Hostname: page-component-7c8c6479df-27gpq Total loading time: 0 Render date: 2024-03-28T22:57:52.549Z Has data issue: false hasContentIssue false

Disorders of the lower gastrointestinal tract

Published online by Cambridge University Press:  17 November 2008

JA Barrett*
Affiliation:
Clatterbridge Hospital, Wirral, Merseyside, UK
*
Department of Geriatric Medicine and Rehabilitation, Clatterbridge Hospital, Wirral, Merseyside, UK.

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Barrett, JA, Chew, D. Disorders of the lower gastrointestinal tract. Rev Clin Gerontol 1991; 1: 119–34.CrossRefGoogle Scholar
2Brewster, NT, Grieve, DC, Saunders, JH. Double contrast barium enema and flexible sigmoidoscopy for routine colonie investigation. Br J Surg 1994; 81: 445–47.Google Scholar
3Irvine, EJ, O'Connor, J, Frost, RA et al. Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v. colonoscopy in rectal bleeding. Gut 1988; 29: 1188–93.CrossRefGoogle ScholarPubMed
4Rex, DK, Weddle, RA, Lehman, GA et al. Flexible sigmoidoscopy plus air contrast barium enema versus colonoscopy for suspected lower gastrointestinal bleeding. Gastroenterology 1990; 98: 855–61.Google Scholar
5Wolf, EL, Frager, D, Beneventano, T. Feasibility of double contrast barium enema in the elderly. AJR 1986; 145: 4748.CrossRefGoogle Scholar
6Steine, S. Will it hurt, doctor? Factors predicting patients' experience of pain during double contrast examination of the colon. BMJ 1993; 307: 100.CrossRefGoogle ScholarPubMed
7Fink, M, Freeman, AH, Dixon, AK, Coni, NK. Computed tomography of the colon in elderly people. BMJ 1994; 308: 1018.CrossRefGoogle Scholar
8Fielding, LP, Phillips, RKS, Hittinger, R. Factors influencing mortality after curative surgery for large bowel cancer in elderly patients. Lancet 1989; i: 595–97.CrossRefGoogle Scholar
9Seymour, DG, Vaz, FG. Aspects of surgery in the elderly: preoperative medical assessment. Br J Hosp Med 1987; 37: 431–35.Google ScholarPubMed
10Barr, H, Brown, SG, Krasner, N, Boulos, PB. Photodynamic therapy for colorectal disease. Int J Colorectal Dis 1989; 4: 1519.Google Scholar
11Krasner, N. Laser therapy in the management of benign and malignant tumours in the colon and rectum. Int J Colorectal Dis 1989; 4: 25.Google Scholar
12Banerjee, A, Shorthouse, A. Towards even fewer colostomies. Lancet 1995; 346: 859.CrossRefGoogle ScholarPubMed
13Williams, NS. Changing patterns in the treatment of rectal cancer. Br J Surg 1989; 76: 56.CrossRefGoogle ScholarPubMed
14Ramirez, JM, Mortensen, NJ McC, Takeuchi, , Smilgin, Humphreys MM. Endoluminal ultra-sonagraphy in the follow-up of patients with rectal cancer. Br J Surg 1994; 81: 692–94.Google Scholar
15Moertel, CG. Chemotherapy for colorectal cancer. N Engl J Med 1994; 330: 1136–42.Google Scholar
16Lewis, AAM, Khoury, GA. Resection for colorectal cancer in the very old: are the risks too high? BMJ 1988; 296: 459–61.Google Scholar
17Austoker, J. Screening for colorectal cancer. BMJ 1994; 309: 382–86.CrossRefGoogle ScholarPubMed
18Thomas, WM, Pye, G, Hardcastle, JD, Mangham, CM. Faecal occult blood screening for colorectal neoplasia: a randomised trial of three days or six days of tests. Br J Surg 1990; 77: 277–79.Google Scholar
19Atkins, WS, Cusick, J, Northover, JMA, Whynes, DK. Prevention of colorectal cancer by once only sigmoidoscopy. Lancet 1993; 341: 736–40.Google Scholar
20Ferguson, A. Ulcerative colitis and Crohn's disease. BMJ 1994; 309: 355–56.CrossRefGoogle ScholarPubMed
21Jewell, DP. Aetiology and pathogenesis of ulcerative colitis and Crohn's disease. Postgrad Med J 1989; 65: 718–19.CrossRefGoogle ScholarPubMed
22Gupta, S, Savertmuttu, SH, Keshavarzian, A, Hodgson, HJF. Is the pattern of inflammatory bowel disease different in the elderly.? Age Ageing 1985; 14: 366–70.CrossRefGoogle ScholarPubMed
23Zimmerman, J, Gavish, D, Rachmilewitz, D. Early and late onset ulcerative colitis. Distinct clinical features. J Clin Gastroenterol 1985; 7: 492–98.Google Scholar
24Jones, HW, Hoare, AM. Does ulcerative colitis behave differently in the elderly? Age Ageing 1988; 17: 410–14.CrossRefGoogle ScholarPubMed
25Rao, SC, Read, NW, Davison, PA, Bannister, JJ, Holdsworth, CD. Anorectal sensitivity and responses to rectal distension in patients with ulcerative colitis. Gastroenterology 1987; 93: 1270–75.Google Scholar
26Rao, SC, Read, NW, Brown, C, Bruce, C, Holdsworth, CD. Studies on the mechanism of bowel disturbance in ulcerative colitis. Gastroenterology 1987; 93: 1013–19.CrossRefGoogle ScholarPubMed
27Rao, SC, Read, NW, Stobart, JAH, Haynes, WG, Benjamin, S, Holdsworth, CD. Anorectal contractility under basal conditions and during rectal infusion of saline in ulcerative colitis. Gut 1988; 29: 769–77.Google Scholar
28Reddy, SN, Bazzochi, G, Ghan, S et al. Colonie motility and transit in health and ulcerative colitis. Gastroenterology 1991; 101: 1289–97.CrossRefGoogle Scholar
29Ruddell, WSJ, Dickinson, RJ, Dixon, MF, Axon, ATR. Treatment of distal ulcerative colitis in relapse: comparison of hydrocortisone enemas and rectal hydrocortisone foam. Gut 1980; 21: 885–89.Google Scholar
30Hawkey, CJ, Hawthorne, AB. Medical treatment of ulcerative colitis: scoring the advances. Gut 1988; 29: 1298–303.CrossRefGoogle ScholarPubMed
31Jarnerot, G. New salicylates as maintenance treatment in ulcerative colitis. Gut 1994; 35: 1155–58.CrossRefGoogle ScholarPubMed
32Riley, SA, Mani, V, Goodman, MJ, Herd, ME, Dutt, S, Turnberg, LA. Comparison of delayed release 5-aminosalicylic acid (mesalazine) and sulfasalazine in the treatment of mild to moderate ulcerative colitis relapse. Gut 1988; 29: 669–74.Google Scholar
33Riley, SA, Mani, V, Goodman, MJ, Herd, ME, Dutt, S, Turnberg, LA. Comparison of delayed release 5-aminosalicylic acid (mesalazine) and sulfasalazine as maintenance treatment for patients with ulcerative colitis. Gastroenterology 1988; 94: 1383–89.Google Scholar
34Meyers, S, Sacher, DB, Present, DH, Janowitz, B. Olsalazine sodium in the treatment of ulcerative colitis among patients intolerant of sulfasalazine. A prospective, randomised, placebo-controlled, double-blind, dose-ranging trial. Gastroenterology 1987; 93: 1255–62.CrossRefGoogle Scholar
35Courtney, MG, Nunes, DP, Bergin, CF et al. Randomised comparison of olsalazine and mesalazine in prevention of relapse in ulcerative colitis. Lancet 1992; 339: 1279–81.Google Scholar
36Ritchie, JK, Ritchie, SM, McIntyre, PB, Marks, CG. Management of acute severe ulcerative colitis in district hospitals. J R Soc Med 1984; 77: 465–71.CrossRefGoogle ScholarPubMed
37Keighley, MR, Yoshioka, K, Kmiot, W, Heyen, F. Physiological parameters influencing function in restorative proctocolectomy and ileo-pouch-anal anastomosis. Br J Surg 1988; 75: 9971002.CrossRefGoogle ScholarPubMed
38Holdsworth, PJ, Johnston, D. Anal sensation after restorative proctocolectomy for ulcerative colitis. Br J Surg 1988; 75: 993–96.CrossRefGoogle ScholarPubMed
39Phillips, RKS. Pelvic pouches. Br J Surg. 1991; 75: 1025–26.Google Scholar
40Miller, R, Bartolo, DCC, Orrom, WJ, Mortensen, NJ McC, Roe, AM, Cervero, F. Improvement of anal sensation with preservation of the anal transition zone after ileoanal anastomosis for ulcerative colitis. Dis Colon Rectum 1990; 33: 414–18.Google Scholar
41Miller, R, Orrom, WJ, Duthie, G, Bartolo, DCC, Mortensen, NJ McC. Ambulatory anorectal physiology in patients following restorative proctocolectomy for ulcerative colitis: comparison with normal controls. Br J Surg 1990; 77: 895–97.CrossRefGoogle ScholarPubMed
42Kumar, D, Williams, NS. Surgical management of ulcerative colitis. Hospital Update 1990; 16: 113–20.Google Scholar
43Rose, JDR, Roberts, CM, Williams, G, Mayberry, JF, Rhodes, J. Cardiff Crohn's disease jubilee: the incidence over 50 years. Gut 1988; 29: 346–51.Google Scholar
44Shapiro, PA, Peppercorn, MA, Antonioli, DA, Joffe, N, Goldmen, H. Crohn's disease in the elderly. Ann J Gastroenterol 1981; 76: 132–37.Google Scholar
45Fabricus, PJ, Gyde, SN, Shouler, P, Keighley, MRB, Alexander-Williams, J, Allan, RN. Crohn's disease in the elderly. Gut 1985; 26: 461–65.CrossRefGoogle Scholar
46Harper, PC, McAuliffe, TL, Beekon, WL. Crohn's disease in the elderly: a statistical comparison with younger patients matched for sex and duration of the disease. Arch Intern Med 1986; 146: 753–55.CrossRefGoogle Scholar
47Brandt, LJ, Boley, SJ, Goldberg, L, Mitsudo, S, Berman, A. Colitis in the elderly: a reappraisal. Am J Gastroenterol 1981; 76: 239–45.Google ScholarPubMed
48Ursing, B, Aim, T, Barany, F et al. A comparative study of metronidazole and sulfasalazine for active Crohn's disease. The cooperative Crohn's disease study in Sweden. II: Results. Gastroenterology 1982; 83: 550–62.Google Scholar
49Prior, P, Gyde, S, Cooke, WT, Waterhouse, JAH, Allan, RN. Mortality in Crohn's disease. Gastroenterology 1981; 80: 307–12.CrossRefGoogle ScholarPubMed
50Elliott, PR, Ritchie, JK, Lennard-Jones, JE. Prognosis in colonie Crohn's disease. BMJ 1985; 291: 178.Google Scholar
51Jones, HW, Grogono, J, Hoare, AM. Surveillance in ulcerative colitis: burdens and benefits. Gut 1988; 29: 325–31.CrossRefGoogle Scholar
52Axon, ATR. Cancer surveillance in ulcerative colitis – a time for reappraisal. Gut 1994; 35: 587–89.Google Scholar
53Greenstein, AJ, Meyers, S, Szporn, A, Slater, G, Janowitz, HD, Antses, AH. Colorectal cancer in regional ileitis. Q J Med 1987; 62: 3340.Google ScholarPubMed
54Riley, TV, Codde, JP, Rouse. Increased length of hospital stay due to Clostridium difficile – associated diarrhoea. Lancet 1995; 345: 455–56.Google Scholar
55Tabaqchali, S, Jumaa, P. Diagnosis and management of Clostridium difficile infection. BMJ 1995; 310: 1375–80.CrossRefGoogle ScholarPubMed
56Kelly, CP, Pothoulakis, C, LaMont, JT. Clostridium difficile colitis. N Engl J Med 1994; 330: 257–62.CrossRefGoogle ScholarPubMed
57Department of Health/Public Health Laboratory Service Joint Working Group. Clostridium difficile infection. Prevention and management. Heywood, Lancashire: Department of Health Publications Unit, 1994.Google Scholar
58Bartlett, JG. Treatment of Clostridium difficile colitis. Gastroenterology 1985; 89: 1192–95.CrossRefGoogle ScholarPubMed
59Barrett, JA. Faecal incontinence in the older adult. London: Edward Arnold, 1993.Google Scholar
60Read, NW, Haynes, WG, Bartolo, DCC et al. Use of anorectal manometry during rectal infusion of saline to investigate sphincter function in incontinent patients. Gastroenterology 1983; 85: 105–13.Google Scholar
61Frenckner, B, Euler, CV. Influence of pudendal nerve block on the function of the anal sphincter in man. Gut 1975; 16: 482–89.Google Scholar
62Rogers, J, Henry, MM, Misiewicz, JJ. Combined sensory and motor deficit in primary neuropathic faecal incontinence. Gut 1988; 29: 59.Google Scholar
63Gibbons, CP, Trowbridge, EA, Bannister, JJ, Read, NW. Role of anal cushions in maintaining continence. Lancet 1986; i: 886–88.Google Scholar
64Connell, AM, Hilton, C, Irvine, G, Lennard-Jones, JE, Misiewicz, JJ. Variation of bowel habits in two population samples. BMJ 1965; 2: 1095–99.CrossRefGoogle ScholarPubMed
65Read, NW, Abouzekry, L, Read, MG, Howell, P, Ottewell, D, Doneely, TC. Anorectal function in elderly patients with faecal impaction. Gastroenterology 1985; 89: 959–66.CrossRefGoogle Scholar
66Resende, TL. Constipation, faecal incontinence and the effects of exercise and abdominal massage on colonic activity in old age [Thesis]. Manchester: University of Manchester, 1989.Google Scholar
67Donald, IP, Smith, RG, Criukshank, JG, Elton, RA, Stoddart, ME. A study of constipation in the elderly living at home. Gerontology 1985; 31: 112–18.Google Scholar
68Barrett, JA. Effect of wheat bran on stool size. BMJ 1988; 296: 1127–28.Google Scholar
69Barrett, JA. A study of the pathophysiology of faecal incontinence among geriatric patients [Thesis]. Liverpool: University of Liverpool, 1988.Google Scholar
70Smith, RG, Lewis, S. The relationship between digital rectal examination and abdominal radiographs in elderly patients. Age Ageing 1990; 19: 142–43.CrossRefGoogle ScholarPubMed
71Bartram, CI, Sultan, AH. Anal endosonography in faecal incontinence. Gut 1995; 37: 46.CrossRefGoogle ScholarPubMed
72Sultan, AH, Kamm, MA, Nicholls, RJ, Bartram, CI. Prospective study of the extent of lateral anal sphincter division during lateral sphincterotomy. Dis Colon Rectum 1994; 37: 1031–33.CrossRefGoogle ScholarPubMed
73Speakman, CTM, Burnett, SJD, Kamm, MA, Bartram, CI. Sphincter injury after anal dilatation demonstrated by anal endosonography. Br J Surg 1991; 78: 1429–30.Google Scholar
74Nielsen, MB, Hauge, C, Rasmussen, OO, Sorensen, M, Pedersen, JF, Christiansen, J. Anal sphincter size measured by endosonography in healthy volunteers. Acta Radial 1992; 33: 453–56.Google Scholar
75Felt-Bersma, RJF, Cuesta, MA, Koorevaar, M et al. Dis Colon Rectum 1992; 35: 944–49.CrossRefGoogle Scholar
76Falk, PM, Blatchford, GJ, Cali, RL, Christensen, MA. Transanal ultrasound and manometry in the evaluation of faecal incontinence. Dis Colon Rectum 1994; 37: 468–72.Google Scholar
77Meier, R, Beglinger, C, Dederding, JP et al. Influence of age gender, hormonal status and smoking habit on colonie transit time. Neurogastroenterol Motil 1995; 7: 235–38.CrossRefGoogle Scholar
78Whitehead, WE, Drinkwater, D, Cheskin, LJ, Heller, BR, Schuster, MM. Constipation in the elderly living at home: definition, prevalence and relationship to lifestyle and health status. J Am Geriatric Soc 1989; 37 423–29.Google Scholar
79Barrett, JA, Faragher, EB, Kiff, ES, Ferguson, G, Brocklehurst, JC. Why are geriatric patients incontinent of faeces? Clin Sci 1988; 75(suppl 19): 10P.CrossRefGoogle Scholar
80Bassotti, G, Gaburri, M, Imbimbo, B, Peli, MA, Morelli, A. Colonie mass movements in health and in constipation. Gastroenterology 1987; 92: 1310.Google Scholar
81Roe, AM, Bartolo, DCC, Mortensen, NJ McC. Diagnosis and surgical management of intractable constipation. Br J Surg 1986; 73: 854–61.CrossRefGoogle ScholarPubMed
82Hinton, JM, Lennard-Jones, JE, Young, AC. A new method for studying gut transit times using radioopaque markers. Gut 1969; 10: 842–47.CrossRefGoogle Scholar
83Cummings, JH, Jenkins, DJA, Wiggins, HS. Measurement of the mean transit time of dietary residue through the human gut. Gut 1976; 17: 210–18.Google Scholar
84Burkitt, DP, Walker, ARP, Painter, NS. Effect of dietary fibre on stools and transit-times, and its role in the causation of disease. Lancet 1972; ii: 1408–11.Google Scholar
85Brocklehurst, JC, Kirkland, JL, Martin, J, Ashford, J. Constipation in long-stay elderly patients: its treatment and prevention by lactulose, poloxalkol-dihydroxyanthroquinolone and phosphate enemas. Gerontology 1983; 29: 181–84.CrossRefGoogle ScholarPubMed
86Preston, DM, Lennard-Jones, JE. Anismus in chronic constipation. Dig Dis Sci 1985; 30: 413–18.Google Scholar
87Preston, DM, Butler, MG, Smith, B, Lennard-Jones, JE. Neuropathology of slow transit constipation. Gut 1983; 24: A997.Google Scholar
88Krishnamurphy, S, Schiffer, MD, Rohrmann, CA, Ope, CE. Severe idiopathic constipation is associated with a distinctive abnormality of the colonie myenteric plexus. Gastroenterology 1985; 88: 2634.Google Scholar
89Preston, DM, Lennard-Jones, JE. Pelvic colon motility and response to intraluminal bisacodyl in slow transit constipation. Dig Dis Sci 1985; 30: 289–94.Google Scholar
90Smith, B. Effect of irritant purgatives on the myenteric plexus in man and the mouse. Gut 1968; 9: 139–43.Google Scholar
91Devroede, G, Lamarche, J. Functional importance of extrinsic parasympathetic innervation of the distal colon and rectum in man. Gastroenterology 1974; 66: 273–80.Google Scholar
92Devroede, G, Arhan, P, Duguay, C, Tetreault, L, Akrany, M, Percy, B. Traumatic constipation. Gastroenterology 1979; 77: 1258–67.CrossRefGoogle ScholarPubMed
93Singaram, C, Ashraf, W, Gaumnitz, EA, Torbey, C, Sengupta, A, Pfeiffer, R, Quigley, EMM. Dopaminergic defect of enteric nervous system in Parkinson's disease patients with chronic constipation. Lancet 1995; 346: 861–64.Google Scholar
94Youle, MS, Read, NW. Effect of painless rectal distension on gastrointestinal transit of solid meal. Dig Dis Sci 1984; 29: 902906.Google Scholar
95Kellow, JE, Gill, RC, Wingate, DL. Modulation of human upper gastrointestinal motility by rectal distension. Gut 1987; 28: 864–68.Google Scholar
96Bannister, JJ, Timms, JM, Barfield, LJ, Donnelly, TC, Read, NW. Physiological studies in young women with chronic constipation. Int J Colorectal Dis 1986; 1: 175–82.Google Scholar
97Panagamuwa, B, Kumar, D, Ortiz, J, Keighley, MRB. Motor abnormalities in the terminal ileum of patients with chronic idiopathic constipation. Br J Surg 1994;81: 1685–88.Google Scholar
98Barnes, PRH, Lennard-Jones, JE. Balloon expulsion from the rectum in constipation of different types. Gut 1985; 26: 1049–52.Google Scholar
99Read, NW, Timms, JM, Barfield, LJ, Donnelly, TC, Bannister, JJ. Impairment of defaecation in young women with severe constipation. Gastroenterology 1986; 90 5360.Google Scholar
100Turnbull, GK, Lennard-Jones, JE, Bartram, CI. Failure of rectal expulsion as a cause of of constipation: why fibre and laxatives sometimes fail. Lancet 1986; i: 767–69.Google Scholar
101Preston, DM, Lennard-Jones, JE, Thomas, BM. The balloon proctogram. Br J Surg 1984; 71: 2932.Google Scholar
102Bartolo, DCC, Read, NW, Jarratt, JA, Read, MG, Donnelly, TC, Johnson, AG. Differences in anal sphincter function and clinical presentation in patients with pelvic floor descent. Gastroenterology 1983; 85: 6875.Google Scholar
103Womack, NR, Williams, NS, Holmfield, JHM, Morrison, JFB, Simpkins, KC. New method for the dynamic assessment of anorectal function in constipation. Br J Surg 1985; 72 1994–98.Google Scholar
104Kuipers, HC, Bleijeuberg, G, Morree, HDE. The spastic pelvic floor syndrome. Large bowel outlet obstruction caused by pelvic floor dysfunction: a radiological study. Int J Colorectal Dis 1986; 1: 4448.Google Scholar
105Lawson, JN, Nixon, HH. Anal canal pressures in the diagnosis of Hirschsprung's disease. J Paediatr Surg 1967; 2: 544–52.Google Scholar
106Read, NW, Abouzekry, L. Why do patients with faecal impaction have faecal incontinence? Gut 1986; 27: 283–87.Google Scholar
107Bartolo, DCC, Roe, AM, Virjee, J, Mortensen, NJ McC. Evacuation proctography in obstructed defaecation and rectal intussusception. Br J Surg 1985; 72 (suppl): Slll116.Google ScholarPubMed
108Womack, NR, Morrison, JFB, Williams, NS. The role of pelvic floor denervation in the aetiology of idiopathic faecal incontinence. Br J Surg 1986; 73: 404407.CrossRefGoogle ScholarPubMed
109Bannister, JJ, Davison, P, Timms, JM, Gibbons, C, Read, NW. Effect of stool size and consistency on defaecation. Gut 1987; 28: 1246–50.Google Scholar
110Bannister, JJ, Abouzekry, L, Read, NW. Effect of ageing on anorectal function. Gut 1987; 28: 353–57.Google Scholar
111Varma, JS, Bradnock, J, Smith, RG, Smith, AN. Constipation in the elderly. A physiologic study. Dis Colon Rectum 1988; 31: 111–15.CrossRefGoogle ScholarPubMed
112Kerrigan, DD, Lucas, MG, Sun, WM, Donnelly, TC, Read, NW. Idiopathic constipation associated with impaired urethrovesical and sacral reflex function. Br J Surg 1989; 76: 748–51.Google Scholar
113Kamm, MA, Lennard-Jones, JE. Rectal mucosal electrosensitivity testing – evidence of a rectal sensory neuropathy in idiopathic constipation. Dis Colon Rectum 1990; 33: 429–33.CrossRefGoogle ScholarPubMed
114Thomas, TM, Egan, M, Meade, TW. Prevalence and implications of faecal (and double) incontinence. Br J Surg 1985; 72 (suppl): S141.Google Scholar
115Tobin, GW, Brocklehurst, JC. Faecal incontinence in residential homes for the elderly: prevalence, aetiology and management. Age Ageing 1986; 15: 4146.CrossRefGoogle Scholar
116Capewell, AE, Primrose, WR, Maclntyre, C. Nursing dependency in registered nursing homes and long term geriatric wards in Edinburgh. BMJ 1986; 292: 1719–21.Google Scholar
117Sandford, JRA. Tolerance of debility in elderly dependants by supporters at home: its significance for hospital practice. BMJ 1975; 3: 471–73.CrossRefGoogle Scholar
118Snooks, SJ, Henry, MM, Swash, M. Anorectal incontinence and rectal prolapse: differential assessment of the innervation to puborectalis and external anal sphincter muscles. Gut 1985; 26: 470–76.Google Scholar
119Read, NW, Harford, WV, Schmulen, AC, Read, MG, Santa, Ana CA, Fordtran, JS. A clinical study of patients with faecal incontinence and diarrhoea. Gastroenterology 1979; 76: 747–56.Google Scholar
120Kiff, ES, Swash, M. Slowed conduction in the pudendal nerves in idiopathic (neurogenic) faecal incontinence. Br J Surg 1984; 71: 614–16.Google Scholar
121Snooks, SJ, Swash, M, Henry, MM. Faecal incontinence due to external sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature: a double pathology. Br J Obstet Gynaecol 1985; 92: 824–28.Google Scholar
122Read, NW, Bartolo, DCC, Read, MG. Differences in anal function in patients with incontinence to solids and in patients with incontinence to liquids. Br J Surg 1984; 71: 3942.Google Scholar
123Parks, AG, Swash, M, Urich, H. Sphincter denervation in anorectal incontinence and rectal prolapse. Gut 1977; 18: 656–65.CrossRefGoogle ScholarPubMed
124Beersiek, F, Parks, AG, Swash, M. Pathogenesis of anorectal incontinence. A histometric study of the anal sphincter musculature. J Neurol Sci 1979; 42: 111–27.Google Scholar
125Neill, ME, Parks, AG, Swash, M. Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse. Br J Surg 1981; 68: 531–36.Google Scholar
126Kiff, ES, Swash, M. Normal proximal and delayed distal conduction in the pudendal nerves of patients with idiopathic (neurogenic) faecal incontinence. J Neurol Neurosurg Psychiatry 1984; 47: 820–23.Google Scholar
127Bartolo, DCC, Jarratt, JA, Read, NW. The use of conventional electromyography to assess external sphincter neuropathy in man. J Neurol Neurosurg Psychiatry 1983; 46 1115–18.CrossRefGoogle ScholarPubMed
128Bartolo, DCC, Jarratt, JA, Read, MG, Donnelly, TC, Read, NW. The role of partial denervation of the puborectalis muscle in idiopathic faecal incontinence. Br J Surg 1983; 70: 664–67.Google Scholar
129Kiff, ES, Barnes, PRH, Swash, M. Evidence of pudendal neuropathy in patients with perineal descent and chronic straining at stool. Gut 1984; 25: 1279–82.Google Scholar
130Snooks, SJ, Barnes, PRH, Swash, M, Henry, MM. Damage to the innervation of the pelvic floor musculature in chronic constipation. Gastroenterology 1985; 89: 977–81.Google Scholar
131Snooks, SJ, Swash, M, Henry, MM, Setchell, M. Risk factors in childbirth causing damage to the pelvic floor innervation. Br J Surg 1985; 72 (suppl): S15–S17.Google Scholar
132Snooks, SJ, Setchell, M, Swash, M, Henry, MM. Injury to the innervation of the pelvic floor musculature in childbirth. Lancet 1984; ii: 546–50.Google Scholar
133Snooks, SJ, Swash, M, Mathers, SE, Henry, MM. Effect of vaginal delivery on the pelvic floor: a 5-year follow up. Br J Surg 1990; 77: 1358–60.CrossRefGoogle ScholarPubMed
134Sultan, AH, Kamm, MA, Hudson, CN, Thomas, JM, Bartram, CI. Anal sphincter disruption during vaginal delivery. N Engl J Med 1993; 329: 1905–11.Google Scholar
135Sultan, AH, Kamm, MA, Bartram, CI, Hudson, CN. Anal sphincter trauma during instrumental delivery. Int J Gynaecol Obstet 1993; 43: 263–70.Google Scholar
136Burnett, SJD, Spence-Jones, C, Speakman, CTM, Kamm, MA, Hudson, CN, Bartram, CI. Unsuspected sphincter damage following childbirth revealed by anal endosonography. Br J Radiol 1991; 64: 225–27.Google Scholar
137Deen, KI, Kumar, D, Williams, JG, Olliff, J, Keighley, MRB. The prevalance of anal sphincter defects in faecal incontinence: a prospective study. Gut 1993; 34: 685–88.Google Scholar
138Engel, AF, Kamm, MA, Sultan, AH, Bartram, CI, Nicholls, RJ. Anterior anal sphincter repair in patients with obstetric trauma. Br J Surg 1994; 81: 1231–34.CrossRefGoogle ScholarPubMed
139Nielsen, MB, Dammegaard, L, Pedersen, JF. Endosonographic assessment of the anal sphincter after surgical reconstruction. Dis Colon Rectum 1994; 37: 434–38.Google Scholar
140Cornes, H, Bartolo, DCC, Stirrar, GM. Changes in anal sensation after childbirth. Br J Surg 1991; 78: 7477.CrossRefGoogle ScholarPubMed
141Matheson, DM, Keighley, MRB. Manometric evaluation of rectal prolapse and faecal incontinence. Gut 1981; 22: 126–29.Google Scholar
142Laurberg, S, Swash, M. Effects of ageing on the anorectal sphincters and their innervation. Dis Colon Rectum 1989; 32: 737–42.Google Scholar
143Percy, JP, Neill, ME, Kandiah, TK, Swash, M. A neurogenic factor in faecal incontinence in the elderly. Age Ageing 1982; 11: 175–79.Google Scholar
144Neill, ME, Swash, M. Increased motor unit fibre density in the external anal sphincter in ano-rectal incontinence: a single fibre EMG study. J Neurol Neurosurg Psychiatry 1980; 43: 343–47.Google Scholar
145Grimby, G, Saltin, B. Mini-review. The ageing muscle. Clin Physiol 1983; 3: 209–18.Google Scholar
146Barrett, JA, Brocklehurst, JC, Kiff, ES, Ferguson, G. Anal function in geriatric patients with faecal incontinence. Gut 1989; 30: 1244–51.Google Scholar
147Jameson, JS, Chia, YW, Kamm, M, Speakman, CTM, Chye, YH, Henry, MM. Effect of age, sex and parity on anorectal function. Br J Surg 1994; 81: 1689–92.Google Scholar
148Frenckner, B. Function of the anal sphincters in spinal man. Gut 1975; 16: 638–44.Google Scholar
149Wheatley, IC, Hardy, KJ, Dent, J. Anal pressure studies in spinal patients. Gut 1977; 18: 488–90.Google Scholar
150Loening-Baucke, V, Anuras, S. Anorectal manometry in healthy elderly subjects. J Am Geriatr Soc 1984; 32: 636–39.Google Scholar
151McHugh, SM, Diamant, NE. Effect of age and gender and parity on anal canal pressures. Dig Dis Sci 1987; 32: 726–36.Google Scholar
152Burnett, SJ, Bartram, CI. Endosonographic variations in the normal internal anal sphincter. Int J Colorectal Dis 1991; 6: 24.Google Scholar
153Swash, M, Gray, A, Lubowski, DZ, Nicholls, RJ. Ultrastructure changes in internal anal sphincter in neurogenic faecal incontinence. Gut 1988; 29: 1692–98.Google Scholar
154Tobin, GW. Incontinence in the elderly. Practitioner 1987; 231: 843–47.Google Scholar
155Roe, AM, Bartolo, DCC, Mortensen, NJ McC. New method for assessment of anal sensation in various anorectal disorders. Br J Surg 1986; 73: 310–12.Google Scholar
156Miller, R, Bartolo, DCC, Cervero, F, Mortensen, NJ McC. Anorectal temperature sensation: a comparison of normal and incontinent patients. Br J Surg 1987; 74: 511–15.Google Scholar
157Read, NW, Read, MG. Role of anal sensation in preserving continence. Gut 1982; 23: 345–47.Google Scholar
158Barrett, JA, Brocklehurst, JC, Kiff, ES, Ferguson, G, Faragher, EB. Rectal motility studies in geriatric patients with faecal incontinence. Age Ageing 1990; 19: 311–17.Google Scholar
159Buser, WD, Miner, PB. Delayed rectal sensation with faecal incontinence. Successful treatment using anorectal manometry. Gastroenterology 1986; 91: 1186–91.Google Scholar
160Wald, A, Tunuguntla, AK. Anorectal sensorimotor dysfunction in faecal incontinence and diabetes mellitus. Modification with biofeedback therapy. N Engl J Med 1984; 310: 1282–87.Google Scholar
161Ferguson, GH, Redford, J, Barrett, JA, Kiff, ES. The appreciation of rectal distension in faecal incontinence. Dis Colon Rectum 1989; 32 964–67.Google Scholar
162Brocklehurst, JC, Andrews, K, Richards, B, Laycock, PJ. Incidence and correlates of incontinence in stroke patients. J Am Geriatr Soc 1985; 33: 540–42.Google Scholar
163Smith, LJ, Smith, PS. Psychological aspects of faecal incontinence in the elderly. In: Barrett, JA ed. Faecal incontinence and related problems in the older adult. Sevenoaks: Edward Arnold, 1993: 173206.Google Scholar
164Barrett, JA. ABC of colorectal diseases: colorectal disorders in the elderly. BMJ 1992; 305: 764–66.Google Scholar
165Ardron, ME, Main, ANH. Management of constipation. BMJ 1990; 300: 1400.Google Scholar
166Farthing, MJG. Irritable bowel, irritable body, or irritable brain. BMJ 1995; 310: 171–75.Google Scholar
167Francis, CY, Whorwell, PJ. Bran and irritable bowel syndrome: time for reappraisal. Lancet 1994; 344: 3940.Google Scholar
168LaMont, JT. Why fibre is good for you. Lancet 1994; 343: 372.Google Scholar
169Thompson, WG. Doubts about bran. Lancet 1994; 344: 3.Google Scholar
170Bateman, DN, Smith, JM. A policy for laxatives. BMJ 1989; 298: 188.Google Scholar
171Goodman, J, Pang, J, Bessman, AN. Dioctyl sodium sulphasuccinate – an ineffective prophylactic laxative, J Chronc Dis 1976; 29: 5963.CrossRefGoogle ScholarPubMed
172Schiller, LR, Santa, Ana CA, Morawski, SG, Fordtran JS. Mechanism of the anti-diarrheal effect of loperamide. Gastroenteology 1984; 86: 1475–80.Google Scholar
173Kachel, G, Ruppin, H, Hagel, J, Barina, W, Meinhardt, M, Domschke, W. Human intestinal motor activity and transport: effects of a synthetic opiate. Gastroenterology 1981; 90: 8593.Google Scholar
174Rattan, S, Culver, PJ. Influence of loperamide on the internal anal sphincter in the oppossum. Gastroenterology 1987; 93: 121–28.Google Scholar
175Read, M, Read, NW, Barber, DC, Duthie, HL. Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhoea with faecal incontinence and urgency. Dig Dis Sci 1982; 27: 807–14.Google Scholar
176Smith, I, Carr, NM, Corrado, O, Young, A. Rectal necrosis after a phosphate enema. Age Ageing 1987; 16: 328–30.Google Scholar
177Sweeney, JL, Hewett, P, Riddel, P, Hoffman, DC. Rectal gangrene: a complication of phosphate enema. Med J Aust 1986; 114: 374–75.Google Scholar
178Abd-el-Maeboud, KH, El-Naggar, , El-Hawi, EMM, Mahmoud, SAR, Abd-el-Hay, S. Rectal suppository: common sense and mode of insertion. Lancet 1991; 338: 798800.Google Scholar
179Smith, RG, Currie, JEJ, Walls ADF Whole gut irrigation: a new treatment for constipation. BMJ 1978; 2: 396–97.Google Scholar
180Foord, KD, Morcos, SK, Ward, P. A comparison of mannitol and magnesium citrate preparations for double contrast barium enema. Clin Radial 1983; 34: 309–12.Google Scholar
181Papachrysostomou, M, Smith, AN. Effects of biofeedback on obstructive defaecation – reconditioning of the defaecation reflex? Gut 1994; 35: 252–56.Google Scholar
182MacDonagh, RP, Sun, WM, Smallwood, R, Foorster, D, Read, NW. Control of defaecation in patients with spinal injuries by stimulation of sacral anterior nerve roots. BMJ 1990; 300: 1494–97.Google Scholar
183Matzel, KE, Stadelmaier, U, Hohenfellner, M, Gall, FP. Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence. Lancet 1995; 346: 1124–27.Google Scholar
184Malone, PS, Ransley, PG, Kiely, EM. Preliminary report: the antegrade colonie enema. Lancet 1990; 336: 1217–18.Google Scholar
185Hill, J, Stott, S, MacLennan, I. Antegrade enemas for the treatment of severe idiopathic constipation. Br J Surg 1994; 81: 1490–91.Google Scholar
186Rands, G, Malone, Lee J. Urinary and faecal incontinence in long stay wards for the elderly mentally ill; prevalence and difficulties in management. Health Trends 1991; 22: 161–63.Google Scholar
187Barrett, JA. Treatment of faecal incontinence secondary to cerebral disease. In: Barrett, JA ed. Faecal incontinence and related problems in the older adult. Sevenoaks: Edward Arnold, 1993: 153–56.Google Scholar
188Parks, AG. Post-anal perineorrhaphy for rectal prolapse. Proc R Soc Med 1967; 60: 920–21.Google Scholar
189Henry, MM, Simson, JNL. Results of postanal repair: a retrospective study. Br J Surg 1985; 72(suppl): S17–S19.Google Scholar
190Setti, Carraro P, Kamm, MA, Nicholls, RJ. Longterm results of postanal repair for neurogenic faecal incontinence. Br J Surg 1994; 81: 140–44.Google Scholar
191Deen, KI, Grant, E, Billingham, C, Keighley, MRB. Abdominal resection rectopexy with pelvic floor repair versus perineal rectosigmoidectomy and pelvic floor repair for full-thickness rectal prolapse. Br J Surg 1994; 81: 302304.Google Scholar