Abstract
Objective: Fecal incontinence affects up to 15% of the general population, with higher rates of incidence among women and the elderly. Acupuncture is an old practice of Traditional Chinese Medicine that might be used to treat fecal incontinence. The aim of this mini review was to assess the effect of acupuncture for fecal incontinence. Materials and Methods: Cochrane Library, Web of Science, Embase, PubMed, and CENTRAL electronic databases were searched until August 2020. The following keywords were used: acupuncture, electroacupuncture, moxibustion, fecal incontinence, diarrhea, irritable bowel syndrome, and bowel dysfunction. In addition, references were searched. Five studies (two randomized controlled trials), out of 52,249 predefined publications after an electronic database search, were included into the review. Results: Overall, 143 patients were included. All studies report significant improvements in continence, although they all apply different acupuncture regimens. Randomized controlled trials show significant differences in experimental groups treated with acupuncture in improving continence. Significant improvement in quality of life scores was reported. In addition, improvement in fecal continence remained significantly improved after 18 months of follow-up. Conclusion: Acupuncture is a promising treatment alternative for fecal incontinence. Based on small, low-quality studies, it might be a safe, inexpensive, and efficient method. However, more high-quality studies are needed in order to apply this treatment technique routinely.
Highlights
Fecal incontinence (FI) can be defined as involuntary loss of flatus and/or liquid or solid stool [1]
Fecal incontinence is a debilitating condition, as it might occur at socially unacceptable situations, leading to embarrassment, and it causes hygiene problems, a considerable impact on sexual life, and social stigma formation, altogether impairing the quality of life (QOL), which might be defined as the overall comfort, happiness, and well-being experienced by an individual
Duplicates and studies not related to FI or acupuncture treatment were excluded, leaving
Summary
Fecal incontinence (FI) can be defined as involuntary loss of flatus and/or liquid or solid stool [1]. Age and gender, more frequently affecting females, up to 40% in elderly women and even higher rates in specific groups with co-morbid conditions [2]. Fecal incontinence is a debilitating condition, as it might occur at socially unacceptable situations, leading to embarrassment, and it causes hygiene problems, a considerable impact on sexual life, and social stigma formation, altogether impairing the quality of life (QOL), which might be defined as the overall comfort, happiness, and well-being experienced by an individual. Treatment options include conservative methods, covering personal hygiene, diet control, pharmacological therapy, physiotherapy techniques for pelvic floor muscles, percutaneous tibial nerve stimulation (PTNS), transanal irrigation (TAI), and anal plug usage; minimal invasive means, including sacral neuromodulation (SNM), antegrade irrigation, anal radiofrequency (SECCA), and intrasphincteric injections; and surgical approaches, including sphincter repair, graciloplasty, artificial sphincter, and colostomy.
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