Email: enquiries@pelvichealthandwellbeing.co.uk
Faecal Incontinence
Faecal incontinence affects quite a significant number of patients with most of the patients presenting with urge incontinence where you are unable to hold on when you have to go to the toilet.
People also complain of faecal seepage where you can end up having a leak without knowing that you have actually had an accident or faecal soiling which can happen in a group of patients. Though the majority of the patients are women it does also affect men and can include all age groups. Sometimes this could be the effect of previous surgery in the form of either open haemorrhoidectomy or lateral sphincterotomy which is carried out for fissures. These issues can also appear spontaneously without an actual cause.
The treatments include managing with constipation medications and laxatives or enemas, physiotherapy which is a main line treatment, irrigation again forms a part of treating faecal incontinence. We also undertake anorectal physiology to assess the sphincter function and an anal ultrasound to assess the sphincter tone and whether there is any damage of the sphincters. Surgical options include SphinKeeper where we are able to put artificial implants around the intersphincteric space to help strengthen the muscles which works well in selective patients, stoma formation, tibial nerve stimulation, sacral nerve stimulation and artificial sphincters.
There are a range of treatments and depending on the patient, we can discuss various treatment plans. The multi-modal treatment and multi-disciplinary team MDT team approach where we are able to discuss patients in detail and come up with the optimal treatment strategy between myself, my physiotherapy colleague and pelvic floor specialist nurse.
OUR OTHER SERVICES
Rectal Prolapse
This can be a debilitating condition. I currently undertake Laparoscopic ventral mesh rectopexy (Lap VMR),
Delormes procedure, Altemeier’s procedure Unfortunately can affect elderly patients who can be frail.
Faecal
Incontinence
Faecal Incontinence affects a significant number of patients with almost 20% of patients thought to be affected. Until recently treatment options were limited. Most patients present following obstetric injury.
Constipation
One of the commonest diagnoses with up to 20% of the population suffering. Primary or secondary to other medical conditions which can include neurological and metabolic conditions.
Obstructive Defecation
Obstructive defection affects a group of patients who normally present with symptoms similar to constipation. We do assess this as a separate group of as the issues tend to be related with opening their bowels.
Haemorrhoidal Treatment
Although haemorrhoids are responsible for considerable economic cost and personal suffering. These account for one of the commonest anorectal diagnoses in outpatients and emergency depts.
Anal Fissures
One of the common conditions that we see but the one that affects patients quite significantly where they are unable to open their bowels and when they do, the muscle spasm causes them significant pain and discomfort.
Anal Fistulas
Anal fistulas can be quite a difficult problem to treat and this generally follows patients who have perianal abscesses which are either drained or sometimes discharge spontaneously or are treated successfully with antibiotics.
Pilonidal Sinus Disease
Pilonidal sinus disease (PD) is most commonly seen in and around the natal cleft. The reported incidence is around 25 per 100,000 with a male to female ratio between 3:1 and 4:1.
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