References on Bowel Dysfunction – Interesting Articles and Research Faecal incontinence Title: Management of Faecal Incontinence Citation: Independent Nurse, March 2011, www.independentnurse.co.uk Author(s): Ness, W Abstract: Faecal incontinence is a distressing and socially debilitating problem Wendy Ness discusses its prevalence and assessment, and simple conservative treatments Title: Percutaneous tibial nerve stimulation for patients with faecal incontinence. Citation: Nursing Standard, February 2011, vol./is. 25/24(44-8), 0029-6570 (2011 16 Feb) Author(s): Allison, M Abstract: The use of percutaneous tibial nerve stimulation (PTNS) as a non-invasive treatment for faecal incontinence. The experience of using PTNS in a nurse-led clinic at the Royal London Hospital, including an audit of treatment outcomes, is described. Its efficacy and cost-effectiveness in the outpatient setting are considered. 19 refs. Title: Management of faecal incontinence in acutely ill patients. Citation: Nursing Standard, February 2011, vol./is. 25/22(48-58), 0029-6570 (2011 2 Feb) Author(s): Hurnauth, C Abstract: Continuing Professional Development, NS578. Use of drainage systems to manage faecal incontinence in patients who are acutely ill. The process of defecation, causes and risk factors in incontinence and assessment tools to measure severity are outlined. The physical, financial and psychological effects are examined and indications or contraindications for using conventional passive drainage methods or active drainage systems are listed. 26 refs. Title: Incontinence after childbirth. Citation: Practice Nurse, December 2010, vol./is. 40/10(41-4), 0953-6612 (2010 10 Dec) Author(s): Mullins, E, Wales, N, Domoney, C Abstract: Causes, prevalence and treatments for women with urinary or faecal incontinence following childbirth. Reasons for delays and non-reporting of symptoms which impact upon lifestyle are discussed, along with assessment of symptoms. A range of individualised therapies, including pelvic floor exercises, bladder training, drug therapies or surgical interventions are described. 30 refs. Title: Solving soiling problems needs collaboration between family, health and education services. Citation: Nursing Times, November 2010, vol./is. 106/47(21), 0954-7762 (2010 30 Nov) Author(s): Jacques, E Abstract: Case study of a 5-year-old with episodes of faecal incontinence at school due to faecal impaction. The involvement of parents and the school nurse in the management of the child and the response of teachers are described. 1 ref. Title: Faecal incontinence: assessment and conservative management. Citation: Gastrointestinal Nursing, October 2010, vol./is. 8/8(18-22), 1479-5248 (2010 Oct) Author(s): Apau, D Abstract: Causes, assessment and non-surgical management of faecal incontinence, including lifestyle change, bowel training, drug therapy and biofeedback. 18 refs. 1 Title: Anal sphincter repair for fecal incontinence: experience from a tertiary care centre. Citation: Indian Journal of Gastroenterology, July 2010, vol./is. 29/4(162-5), 02548860;0975-0711 (2010 Jul) Author(s): Chase S, Mittal R, Jesudason MR, Nayak S, Perakath B Language: English Abstract: AIM: Structural anal sphincter damage may be secondary to obstetric anal sphincter injury, perineal trauma or anorectal surgery. We reviewed the spectrum of anal sphincter injuries and their outcomes in a tertiary care colorectal unit.METHODS: Data of patients who underwent anal sphincter repair between 2004 and 2008 were analyzed retrospectively. Outcomes were compared with respect to etiology, type of repair, previous attempts at repair and manometry findings. Outcomes were defined as good or poor based on patient satisfaction as the primary criteria.RESULTS: Thirty-four patients underwent anal sphincter repair. Twenty-two injuries were obstetric, eight traumatic, and four iatrogenic. All patients underwent overlap sphincteroplasty with six additional anterior levatorplasty and seven graciloplasty. Twenty-three (67.6%) patients had a good outcome while nine (26.4%) had a poor outcome. All patients who had augmentation anterior levatorplasty had a good outcome. Fifty percent of patients with a previous sphincter repair and 42.9% requiring augmentation graciloplasty had a poor outcome. Median resting and squeeze anal pressures increased from 57.5 to 70 cmH2O and 90.25 to 111 cmH2O in those with a good outcome.CONCLUSIONS: Overlap sphincteroplasty has a good outcome in majority of the patients with incontinence due to a structural sphincter defect. Additional anterior levatorplasty may improve outcomes. Previous failed repairs or use of a gracilis muscle augmentation may have a worse outcome secondary to poor native sphincter muscle. Improvement in resting and squeeze pressures on anal manometry may be associated with a good outcome. Title: Using biofeedback to treat constipation, faecal incontinence and other bowel disorders. Citation: Nursing Times, September 2010, vol./is. 106/37(18-21), 0954-7762 (2010 21 Sep) Author(s): Burch, J, Collins, B Abstract: Definition and principles of biofeedback and its use in the management of constipation and faecal incontinence. Services available and diagnostic tests used are described and the components of education, bowel and muscle retraining, behavioural therapy and psychological support are explained. 25 refs. Title: Faecal incontinence in older people: delivering effective, dignified care. Citation: Br J Community Nursing, August 2010, vol./is. 15/8(370-4), 1462-4753 (2010 Aug) Author(s): Smith, B Abstract: Risk factors and strategies for caring for elderly people with faecal incontinence living in the community. Competencies for continence care identified from the Skills for Health Framework (Department of Health, 2004), nutritional, bowel and constipation interventions and conflict between health and social care concerning incontinence management are discussed. 17 refs. 2 Title: The efficacy of external neuromyogenic stimulation on neuromuscular anorectal incontinence. Citation: European Journal of Pediatric Surgery, July 2010, vol./is. 20/4(230-3), 09397248;1439-359X (2010 Jul) Author(s): Ergun O, Tatlisu R, Pehlivan M, Celik A Abstract: AIM: This study reports on the preliminary results of external neuromyogenic electrostimulation (ENS) for the treatment of anorectal continence problems.PATIENTS AND METHODS: A total of seventeen patients with anorectal malformations (n=11), Hirschsprung's disease (n=5) or pelvi-perineal trauma (n=1) were included in the study. All patients were evaluated using clinical, radiological, and manometric methods prior to ENS. The Holschneider Continence Scale and the Quality of Life (QOL) Score were used for clinical assessment. The ENS stimulator is a two-channel ambulatory device providing a pulse current. ENS was performed by parents in a home setting twice daily for 6 weeks using skin electrodes attached to the sides of the anus. Three of the 11 preset programs were used (lack of sensitivity, pelvic floor work out and building up endurance). Clinical and manometric variables were reevaluated following completion of the 6-week program.RESULTS: Mean age was 9.7 years (range 5-22 years). The Holschneider Continence Score increased from a mean value of 5.3+/-3.2 to 12.4+/-1.7 (p=0.002) and mean QOL scores increased from 5.6+/-2.3 to 11.6+/-1.8 (p=0.01) following ENS. Mean anal canal resting pressures prior to ENS were 20.3+/-6 cmH (2)O and increased to 28.7+/-14.1 cmH (2)O after 6 weeks (p>0.05). Maximum voluntary squeeze pressures before and after ENS were 56.1+/-16.7 cmH (2)O and 100.7+/-16.9 cmH (2)O respectively (p=0.001).CONCLUSION: Preliminary results for ENS have shown that patients achieved higher maximum voluntary squeeze pressures, and showed a marked improvement in their continence and QOL scores. Given the advantage of ambulatory use in a home setting, the ENS seems promising in terms of achieving improved anorectal continence in selected patients. Title: The management of faecal incontinence in acute settings. Citation: Continence UK, June 2010, vol./is. 4/2(52-5), 1753-8890 (2010 Jun) Author(s): Ousey, K, Gillibrand, W, York, L Abstract: Research in an acute hospital in west Yorkshire among intensive therapy unit patients experiencing faecal incontinence to examine the prevalence and management of the condition and develop a guideline. Groups at risk of faecal incontinence are identified and options including faecal management and collection devices are discussed. 22 refs. Title: Goal setting for faecal incontinence: a patient-centred approach. Citation: Gastrointestinal Nursing, April 2010, vol./is. 8/3(18-24), 1479-5248 (2010 Apr) Author(s): Aston, B, Sheehan, L Abstract: Literature review on the rationale for and use of a patient-centred approach to goal setting in the treatment of faecal incontinence. A case study using a SMART (Specific, measurable, achievable, realistic and timed) goal is included. 24 refs. Title: Faecal incontinence: the final taboo. Citation: Practice Nurse, April 2010, vol./is. 39/7(43-7), 0953-6612 (2010 9 Apr) Author(s): Yates, A Abstract: Advanced Practice series, module 10.03. Symptoms, prevalence, causes, management and psychological impact of faecal incontinence. High risk groups, assessment using detailed histories, food diaries, and bowel or stool diaries making reference to the Bristol Stool Form Scale, and conservative treatments such as providing coping strategies are 3 described. Specialist management including electrical stimulation, bowel retraining, biofeedback and surgical options are discussed. 16 refs. Title: Being involved in an everlasting fight: a life with postnatal faecal incontinence: a qualitative study. Citation: Scandinavian J Caring Sciences, March 2010, vol./is. 24/1(108-15), 0283-9318 (2010 Mar) Author(s): Rasmussen, J, Ringsberg, K Abstract: Qualitative research in Denmark into the experience of living with faecal incontinence caused by complications during childbirth. Interviews with participants affected for at least 6 months after childbirth examined psychological and social aspects of living with the condition and how they coped, including the effect on their self-perception as a woman and the impact on family life and sexuality. 32 refs. Title: Conservative management of faecal incontinence in adults. Citation: Nursing Standard, March 2010, vol./is. 24/26(49-56), 0029-6570 (2010 3 Mar) Author(s): Allison, M Abstract: Continuing Professional Development, NS532 on the assessment and management of patients with chronic faecal incontinence. The causes of incontinence are explored and a faecal incontinence assessment tool is presented. The role of the clinical nurse specialist in advising patients about diet, medication and in promoting bowel control is highlighted. 36 refs. Title: Acquired fecal incontinence in community-dwelling adults. Citation: Nurse Practitioner, January 2010, vol./is. 35/1(14-23), 0361-1817 (2010 Jan) Author(s): Chien, D, Bradway, C Abstract: Incidence, mechanisms, pathophysiology, diagnosis and assessment of faecal incontinence. Conditions and patient characteristics associated with faecal incontinence, including age, obstetric injury, the effects of surgery or radiotherapy and neurological disorders, are identified. Biofeedback, pelvic muscles exercises, urge resistance education, electrical stimulation, skin care and other management options are discussed. 52 refs. Title: Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: six year follow up. Citation: BMJ, February 2005, vol./is. 330/7487(337-9), 0959-8138 Author(s): Glazener, C, Herbison, P, McArthur, C Abstract: Research by randomised controlled trial in Aberdeen, Birmingham and Dunedin to examine the long-term effects of nurse-led conservative interventions for postnatal incontinence. A 6-year follow-up of the interventions, in which nurses assessed urinary incontinence and advised on pelvic floor exercises and bladder training at 5-9 months after delivery, examined the long-term effects and continuation of pelvic floor exercising. 13 refs. Constipation Title: Clinical features, psychological issues and management of constipation in childhood. Citation: Nursing Children & Young People, April 2011, vol./is. 23/3(29-36), 2046-2344 (2011 Apr) Author(s): Cohn, A Abstract: Continuing Professional Development, article NCYP510. Causes and treatment of constipation and stool withholding in children. Normal bowel function, the development of a 4 stool withholding habit and pain are described, together with the associated clinical features. Case studies are presented, complications discussed and treatment using fluid, fibre and laxatives is outlined. 23 refs. Title: Not having the right bowel care is demeaning. Citation: Nursing Times, March 2011, vol./is. 107/12(16), 0954-7762 (2011 29 Mar) Author(s): Penn, R, Coggrave, J Abstract: Personal account by a paraplegic patient of the lack of bowel care received during a hospital admission when he developed faecal impaction and nurses refused to perform manual evacuation. Comments are included from an expert nurse, highlighting the care required by spinal cord injury patients. Title: Does abdominal massage relieve constipation? Citation: Nursing Times, March 2011, vol./is. 107/12(20-2), 0954-7762 (2011 29 Mar) Author(s): McClurg, D, Lowe-Strong, A Abstract: Literature review of research on the use of abdominal massage to relieve constipation. Specific applications with older people, after colon surgery and in MS are explained and the technique is described. 22 refs. Title: Juvenile idiopathic constipation. Citation: Nursing Times, March 2011, vol./is. 107/12(26-8), 0954-7762 (2011 29 Mar) Author(s): Prynn, P Abstract: Symptoms, causes and management of idiopathic constipation in children. Assessment is discussed, including the use of the Bristol Stool Chart, modified for children. 8 refs. Title: Giant faecoloma in young children: a case study. Citation: Emergency Nurse, February 2011, vol./is. 18/9(32-4), 1354-5752 (2011 Feb) Author(s): Rachamim, E Abstract: Case study of a young child presenting at A&E with suspected gastroenteritis which was later diagnosed by x-ray as impacted faeces. Interpretation of the x-ray results, symptoms, assessment and management are described. 2 refs. Title: Effectiveness and tolerability of amidotrizoate for the treatment of constipation resistant to laxatives in advanced cancer patients. Citation: J Pain & Symptom Management, February 2011, vol./is. 41/2(421-5), 0885-3924 (2011 Feb) Author(s): Mercadante, S, Ferrera, P, Casuccio, A Abstract: Quantitative prospective research in Italy evaluating the efficacy and tolerability of amidotrizoate for constipation in advanced cancer patients unresponsive to common laxatives. Adverse effects related to the medication, its impact on other symptoms and associations with patient demographic and clinical characteristics are reported. 9 refs. Title: Using massage to ease constipation. Citation: Nursing Times, February 2011, vol./is. 107/4(26-7), 0954-7762 (2011 1 Feb) Author(s): Lamas, K Abstract: Research in Sweden examining the effectiveness of abdominal massage for patients with constipation. Mainly older people living in communal or private accommodation received 15 minutes abdominal and hand massage weekly in addition to laxatives and the results were compared to a control group. 10 refs. 5 Title: An examination of the effect of castor oil packs on constipation in the elderly. Citation: Complementary Therapies in Clinical Practice, February 2011, vol./is. 17/1(58-62), 1744-3881 (2011 Feb) Author(s): Arslan, G, Eser, I Abstract: Research in Turkey investigating the effect of castor oil packs on constipation in elderly people residing in care homes. The packs were heated and administered to residents with constipation and differences in symptoms were evaluated before, during and after treatment. 52 refs. Title: Effectiveness of aroma massage on advanced cancer patients with constipation: a pilot study. Citation: Complementary Therapies in Clinical Practice, February 2011, vol./is. 17/1(37-43), 1744-3881 (2011 Feb) Author(s): Lai, T, Cheung, M, Lo, C Abstract: Research in Hong Kong assessing the effects of aroma massage therapy on the symptoms of constipation in advanced cancer patients. The McGill quality of life for Hong Kong Chinese (MQOL-HK), and the Constipation Assessment Scale (CAS) were used to measure the results. 27 refs. Title: An examination of the effect of castor oil packs on constipation in the elderly. Citation: Complementary Therapies in Clinical Practice, February 2011, vol./is. 17/1(58-62), 1744-3881 (2011 Feb) Author(s): Arslan, G, Eser, I Abstract: Research in Turkey investigating the effect of castor oil packs on constipation in elderly people residing in care homes. The packs were heated and administered to residents with constipation and differences in symptoms were evaluated before, during and after treatment. 52 refs. Title: Constipation in persons receiving hospice care. Citation: J Pain & Symptom Management, December 2010, vol./is. 40/6(810-20), 0885-3924 (2010 Dec) Author(s): Strassels, S, Maxwell, T, Iyer, S Abstract: Retrospective research in the USA to estimate the prevalence and severity of constipation among hospice patients. Primary diagnosis, demographic characteristics and prescribing of laxatives and opioids are explored. Relationships between constipation and patients' demographic and clinical characteristics are described. 20 refs. Title: Investigating factors associated with functional constipation of primary school children in Hong Kong. Citation: J Clinical Nursing, December 2010, vol./is. 19/23-24(3390-400), 0962-1067 (2010 Dec) Author(s): Chan, M, Chan, Y Abstract: Survey research at a primary school in Hong Kong examining the prevalence of functional constipation among children aged 8-10 years and exploring associated factors. Participants completed questionnaires on their bowel habits, age, gender, intake of fluid, fruit and vegetables and use/non-use of school toilets. The role of school nurses in helping children and families avoid constipation is discussed. 44 refs. 6 Title: Management of constipation. Citation: Br J Healthcare Assistants, December 2010, vol./is. 4/12(592-6), 1753-1586 (2010 Dec) Author(s): Foxley, S, Vosloo, R Abstract: The causes and management of constipation. Constipation, normal bowel function and the process of rectal emptying are outlined and functional or anatomical causes explained. Treatment involving lifestyle, exercise, regular eating and use of laxatives or irrigation is described and the healthcare assistant's role in bowel care procedures is considered. 33 refs. Title: LIFELAX: diet and LIFEstyle versus LAXatives in the management of chronic constipation in older people: randomised controlled trial. Citation: Health Technology Assessment, November 2010, vol./is. 14/52(1-221), 1366-5278 (2010 Nov) Author(s): Speed, C, Heaven, B, Adamson, A Abstract: Research by randomised trial to evaluate the clinical and cost-effectiveness of treatments for constipation in people aged 55 and over. Participating general practices offered either use of laxatives, standardised dietary and lifestyle advice, or personalised dietary and lifestyle advice. The effect of recruitment problems on the trial are reported. 233 refs. Title: Consensus recommendations for the management of constipation in patients with advanced, progressive illness. Citation: J Pain & Symptom Management, November 2010, vol./is. 40/5(761-73), 08853924 (2010 Nov) Author(s): Librach, S, Bouvette, M, De Angelis, C Abstract: Consensus recommendations developed in Canada on constipation management in palliative patients. The process of developing consensus recommendations is outlined. The document's basis on available evidence and expert opinion derived from clinical practice is highlighted, and its recommendations for assessment and management are described. 20 refs. Title: NICE's first guideline on idiopathic childhood constipation aims to standardise practice. Citation: Nursing Times, November 2010, vol./is. 106/47(14), 0954-7762 (2010 30 Nov) Author(s): Hooban, S Abstract: Summary of NICE guidance on idiopathic constipation in children (2010). The recommendations for management are reviewed, with reference to the nurse's role. 1 ref. Title: Landmark guidance puts childhood continence firmly in the spotlight. Citation: Nursing Times, November 2010, vol./is. 106/47(8), 0954-7762 (2010 30 Nov) Author(s): Perez, J Abstract: Comments on new NICE guidelines on childhood idiopathic constipation (2010) and nocturnal enuresis (2010). The role of Education and Resources for Improving Childhood Continence (ERIC) in supporting parents and professionals is discussed. 2 refs. Title: Treatment of idiopathic constipation in children and young people. Citation: Primary Health Care, September 2010, vol./is. 20/7(16-9), 0264-5033 (2010 Sep) Author(s): Dobson, P, Blannin, J Abstract: Discussion of the NICE guidelines 'Constipation in children and young people' (2010) on the diagnosis and management of childhood constipation in primary and secondary 7 care. Definitions of associated terminology, the condition's prevalence, symptoms and causes are outlined. The benefits of early identification and maintenance therapy are explored. 4 refs. Title: Assessment and management of constipation in terminal disease. Citation: End of Life Care, August 2010, vol./is. 4/3(56-63), 1754-1069 (2010 Aug) Author(s): Nancekivell-Smith, R Abstract: Causes, assessment and management of constipation in terminally ill patients, with reference to a case scenario. Signs, symptoms and diagnostic criteria of constipation are discussed, including the Bristol Stool Form Scale, and common types of laxatives are identified. Recommendations are made for monitoring bowel habits and reducing the adverse effects of constipation. 51 refs. Title: Abdominal massage for people with constipation: a cost utility analysis. Citation: J Advanced Nursing, August 2010, vol./is. 66/8(1719-29), 0309-2402 (2010 Aug) Author(s): Lamas, K, Lindholm, L, Engstrom, B Abstract: Research by randomised controlled trial in Sweden into the benefits for quality of life of abdominal massage for constipation. The study also investigated the cost-effectiveness of abdominal massage when administered for 8 weeks by nursing staff for inpatients and when carried out by patients themselves after instruction. Quality of life assessments at 3 points during the treatment are reported. 56 refs Title: Assessing constipation and interventions. Citation: Gastrointestinal Nursing, 2010, vol./is. 8/6(24-7), 1479-5248 (2010 Jul/Aug) Author(s): Apau, D Abstract: Causes, assessment and management of constipation, using both pharmacological and non-pharmacological interventions. Bulk-forming agents, laxatives, stool softeners, suppositories and enemas are discussed and other approaches are briefly identified. 14 refs. Title: Functional constipation: implications for nursing interventions. Citation: J Clinical Nursing, July 2010, vol./is. 19/13-14(1838-43), 0962-1067 (2010 Jul) Author(s): Zhou, L, Lin, Z, Lin, L Abstract: Quantitative research in China examining whether there is a causal relationship between depression or anxiety and functional constipation. Results of an anorectal manometry and anxiety and depression scores were measured in men and women diagnosed with functional constipation and compared with those of healthy volunteers. The implications for psychological nursing care of these patients are considered. 18 refs. Title: Abdominal massage in the management of constipation. Citation: Continence UK, June 2010, vol./is. 4/2(20-4), 1753-8890 (2010 Jun) Author(s): Kyle, G Abstract: Literature review concerning the effectiveness of treating constipation using abdominal massage. Assessment to establish if massage should be considered and guidelines for health professionals on recommended procedures are described and illustrated. 18 refs. 8 Title: NICE provides a consistent and coordinated approach to managing childhood constipation. Citation: Nursing Times, June 2010, vol./is. 106/24(34), 0954-7762 (2010 22 Jun) Author(s): Weaver, A Abstract: Continence Journal supplement. Summary of NICE recommendations (2010) on the management of idiopathic chronic constipation in children and the implications for nurses. 3 refs. Title: Comparison of two bowel treatments to prevent constipation in post-surgical orthopaedic patients. Citation: Int J Orthopaedic & Trauma Nursing, May 2010, vol./is. 14/2(75-81), 1878-1241 (2010 May) Author(s): Madsen, L, Magor, C, Parker, B Abstract: Research in Australia on the effectiveness of Macrogol 3350 with electrolytes (Movicol) to standard bowel treatment for reducing constipation in postoperative orthopaedic patients, compared to standard treatment using Coloxyl and senna. Patients having elective total knee and hip replacement surgery were allocated to the intervention or control group and bowel movements, abdominal symptoms, pain and nausea were recorded daily. 17 refs. Title: Management of constipation. Citation: Learning Disability Practice, May 2010, vol./is. 13/4(26-8), 1465-8712 (2010 May) Author(s): Marsh, L, Caples, M, Dalton, C Abstract: Overview of the prevalence, causes and non-pharmacological management of constipation in people with learning disabilities. A case study is used to illustrate the benefits of a nurse-led 2-hour workshop for patients and their carers to help them recognise causes and symptoms and receive appropriate care. 21 refs. Title: Constipation in people with learning disability. Citation: BMJ, March 2010, vol./is. 340/7745(531-2), 0959-8138 (2010 6 Mar) Author(s): Coleman, J, Spurling, G Abstract: The incidence of constipation in people with learning disabilities and the problems in its diagnosis. Management is outlined, along with the reasons why it is considered significant in adults with learning disabilities. 15 refs. Title: A pilot study of the effectiveness of reflexology in treating idiopathic constipation in women. Citation: Complementary Therapies in Clinical Practice, February 2010, vol./is. 16/1(41-6), 1744-3881 (2010 Feb) Author(s): Woodward, S, Norton, C, Barriball, K Abstract: Research evaluating the use of reflexology to treat idiopathic constipation in women. Participants completed a 6-weeks course of reflexology and were assessed before and after for symptoms of constipation, laxative use and perceived health and anxiety. 35 refs. Title: The older person: management of constipation. Citation: Br J Community Nursing, February 2010, vol./is. 15/2(58-64), 1462-4753 (2010 Feb) Author(s): Kyle, G Abstract: Symptoms of constipation in older people and evidence-based and emerging management options. Functional assessment, dietary factors associated with constipation and 9 types of laxatives are considered. 2 new treatments, the Peristeen trans-anal irrigation system and Relistor for opioid-induced constipation, are described. 42 refs. Title: Opioid induced constipation. Citation: Independent Nurse, January 2010(18), 1747-9800 (2010 18 Jan) Author(s): Kyle, G Abstract: Assessment and management of constipation caused by opioid drugs in palliative care. 6 refs. Title: The impact of opioid-induced constipation on patients near the end of life: perspectives of patients, family caregivers and nurses. Citation: J Hospice & Palliative Nursing, 2010, vol./is. 12/1(29-40), 1522-2179 (2010 Jan/Feb) Author(s): Lentz, J, McMillan, S Abstract: Qualitative research in the USA on the effect of opioid-induced constipation on pain management and quality of life in cancer patients in end-of-life care. Hospice and palliative care nurses, cancer patients and family carers completed a survey about the perceived impact of constipation, frequency of pain, other adverse effects of opioids and time spent by nurses dealing with constipation. 30 refs. Title: Methylnaltrexone: a subcutaneous treatment for opioid-induced constipation in palliative care patients. Citation: Int J Palliative Nursing, November 2009, vol./is. 15/11(533-40), 1357-6321 (2009 Nov) Author(s): Kyle, G Abstract: The prevalence, causes and management of constipation in palliative care patients. Guidance is provided on the assessment of constipation, and on its treatment options, which include bulk-forming laxatives, stimulants, osmotics and iso-osmotics, and softeners. A case study to illustrate the use of methylnaltrexone bromide in opioid-induced constipation is included. 27 refs. Title: Methylnaltrexone treatment of opioid-induced constipation in patients with advanced illness. Citation: J Pain & Symptom Management, November 2009, vol./is. 38/5(683-90), 08853924 (2009 Nov) Author(s): Chamberlain, B, Cross, K, Winston, J Abstract: Quantitative controlled research in the USA and Canada evaluating the safety and efficacy of methylnaltrexone for managing opioid-induced constipation in terminally ill patients in palliative care settings. The impact on bowel status, common laxative use and patient comfort is reported. 21 refs. Title: Reflexology in the management of encopresis and chronic constipation. Citation: Paediatric Nursing, April 2003, vol./is. 15/3(20-1), 0962-9513 (2003 Apr) Author(s): Bishop, E, McKinnon, E, Weir, E Abstract: Research in children between 3 and 14 years of age in Scotland. 5 refs. 10 Pelvic floor Title: How to teach pelvic floor muscle exercises. Citation: Midwives, 2009, vol./is. 12/3(15), 1479-2915 Author(s): Tohill, S, Kettle, C Abstract: How To...series. Teaching pelvic floor muscle exercises, including how to locate pelvic floor muscles. Slow and fast contraction exercises are described, with advice and information on how to perform exercises correctly. Advice on how to prevent urinary incontinence is also outlined. 2 refs. Title: The menopause: effects on the pelvic floor, symptoms and treatment options. Citation: Nursing Times, December 2009, vol./is. 105/48(22-4), 0954-7762 (2009 8 Dec) Author(s): Lee, J Abstract: Physiological effects of ageing on the pelvic floor in postmenopausal women, including the damage to muscles, connective tissue, and the urethra and the later effects of damage during childbirth. The symptoms and management of stress urinary and faecal incontinence are described and the role of pelvic floor dysfunction is discussed. 26 refs Title: Role of the female pelvic floor muscles: a guide for gastrointestinal nurses. Citation: Gastrointestinal Nursing, May 2009, vol./is. 7/4(12-7), 1479-5248 Author(s): Dorey, G Abstract: Anatomy and function of the female pelvic floor muscles and their function in preventing faecal and urinary incontinence. Guidance on controlling faeces and urine, including practical advice on pelvic floor exercises, is given. Types, management and support of vaginal prolapses are also discussed. 9 refs. Title: Role of the male pelvic floor muscles: a guide for gastrointestinal nurses. Citation: Gastrointestinal Nursing, April 2009, vol./is. 7/3(10-4), 1479-5248 Author(s): Dorey, G Abstract: Overview of the anatomy and functions of the male pelvic floor muscles in supporting abdominal contents, controlling urine flow and faecal incontinence, and achieving penile erection. The teaching of pelvic floor exercises for men by qualified nurses is also discussed. 6 refs. Title: Pregnancy and childbirth: the effects on pelvic floor muscles. Citation: Nursing Times, February 2009, vol./is. 105/7(38-41), 0954-7762 Author(s): Herbert, J Abstract: Continence Journal supplement. Effects of pregnancy on the pelvic floor and the development of continence problems. Causes, mechanisms and symptoms of pelvic floor dysfunction are reviewed and risk factors for obstetric anal sphincter injuries are identified. Recommendations are made for improving pelvic floor management in pregnancy and after delivery. 33 refs. Title: Coping mechanisms in women living with pelvic floor dysfunction. Citation: Gastrointestinal Nursing, April 2008, vol./is. 6/3(30-9), 1479-5248 Author(s): Porrett, T, Cox, C Abstract: Ethnographic research with women with pelvic floor dysfunction (PFD) to investigate their coping mechanisms and triggers which prompted them to seek help. Phase 1 of the research, which takes the form of a longitudinal life health history obtained from a woman in her 30s with longstanding PFD, is summarised. 42 refs. 11 Title: Understanding pelvic floor dysfunction and its relevance to colorectal nursing. Citation: Gastrointestinal Nursing, April 2006, vol./is. 4/3(20-6), 1479-5248 Author(s): Porrett, T Abstract: Overview of pelvic floor dysfunction in women including causes and treatments. The current service provision is discussed and the role which colorectal nurse specialists may play in holistic assessment of women with pelvic floor dysfunction and appropriate referral to other specialists is explained. 35 refs. Skin Care Title: Evaluating a skin barrier film in faecal and urinary incontinence. Citation: Wounds UK, June 2010, vol./is. 6/2(107-11), 1746-6814 (2010 Jun) Author(s): Deakin, A, Stapleton, M, Chadwick, K Abstract: Evaluation of the Sorbaderm(R) No-Sting Barrier Film (NSBF) in patients with faecal and urinary incontinence, isolated due to infection with Norovirus or Clostridium difficile. The moisture-related skin damage of patients using Sorbaderm was compared over a 5-day period with that of patients using the usual NSBF, and its effectiveness and ease of use assessed. 5 refs. Title: Prevention and management of incontinence-associated dermatitis. Citation: Drugs & Aging, June 2010, vol./is. 27/6(491-6),1170-229X;1170-229X(2010, Jun) Author(s): Nix D, Haugen V Abstract: Perineal dermatitis, recently relabelled 'incontinence-associated dermatitis' (IAD), is an inflammation of the skin that occurs when urine and/or stool comes into contact with the skin. It can range in severity from erythema with or without loss of skin integrity to infection. IAD affects as many as 41% of adults in long-term care; it is costly, painful and, for the most part, preventable. An effective plan of care for individuals with IAD must include assessment and management of incontinence aetiology, perineal skin and risk assessment, gentle cleansing and moisturization, application of skin barriers and treatment of secondary infection, and the use of containment devices if indicated. General Bowel Dysfunction Title: Assessing and treating people with bowel dysfunction. Citation: Nursing Times, March 2011, vol./is. 107/12(24), 0954-7762 (2011 29 Mar) Author(s): Ness, W Abstract: 5 Minute Briefing series. Assessment and treatment of patients with faecal incontinence and constipation in hospital and the community. Causes of bowel problems are briefly discussed and simple strategies for management are suggested. Criteria for referral are also identified. 4 refs. Title: Why are nurses failing to carry out digital rectal examinations? Citation: Nursing Times, December 2010, vol./is. 106/48(8), 0954-7762 (2010 7 Dec) Author(s): Kyle, G Abstract: Suggestion that nurses are failing to perform digital rectal examinations on patients with faecal incontinence, due to reluctance or ignorance. 2 refs. Title: Ask the Board: what can nurses delegate to healthcare assistants? Citation: Br J Healthcare Assistants, December 2010, vol./is. 4/12(616-7), 1753-1586 Abstract: Principles of accountability in delegation of tasks to healthcare assistants. Particular reference to bowel irrigation procedures is included. 12 Title: Incontinence in women prisoners: an exploration of the issues. Citation: J Advanced Nursing, September 2010, vol./is. 66/9(1953-67), 0309-2402 (2010 Sep) Author(s): Drennan, V, Goodman, C, Norton, C Abstract: Research into the extent of incontinence and other urinary and bowel problems among women in an English prison, in order to help devise policies and procedures for prison health services. The results of the survey were analysed to compare prevalence with women in the general population, to understand how the women coped and the help they received, and education required by prison staff. 78 refs. Title: The physical, social and emotional effects of bowel dysfunction in Parkinson's disease. Citation: Nursing Times, August 2010, vol./is. 106/33(20-2), 0954-7762 (2010 24 Aug) Author(s): Kyle, G Abstract: Impact of bowel dysfunction on quality of life for people with Parkinson disease. Causes of constipation and problems of dysphagia, gastroparesis and functional incontinence are explained. Risk assessment and management strategies are discussed. 22 refs. Title: Use of Peristeen anal irrigation. Citation: Br J Neuroscience Nursing : Better Management of Neurogenic Bowel Dysfunction Supplement, March 2010, vol./is. 6/3(13-5), 1747-0307 (2010 Mar) Author(s): Flynn, D Abstract: Evidence for the use of anal irrigation to manage faecal incontinence and constipation in patients with neurogenic bowel disorder. The procedure for using Peristeen anal irrigation is described and a case study is included. 12 refs. Title: Guidelines for neurogenic bowel management after spinal injury. Citation: Gastrointestinal Nursing : Better Management of Neurogenic Bowel Dysfunction Supplement, March 2010, vol./is. 8/2(7-9), 1479-5248 (2010 Mar) Author(s): Coggrave, M Abstract: Importance of guidelines for bowel management in patients with spinal cord injury. The aims and content of the guidelines initiated by the Multidisciplinary Association of Spinal Cord Injury Professionals (2009) for the management of neurogenic bowel are summarised and discussed. 15 refs. Title: Assessment of bowel dysfunction. Citation: Gastrointestinal Nursing : Better Management of Neurogenic Bowel Dysfunction Supplement, March 2010, vol./is. 8/2(10-2), 1479-5248 (2010 Mar) Author(s): Kyle, G Abstract: Importance of nurses undertaking a thorough assessment of patients with constipation and faecal incontinence in order to plan appropriate care and improve quality of life. Functional assessment, digital rectal examination and other investigations are explained. 18 refs. Title: Rectal irrigation for patients with functional bowel disorders. Citation: Nursing Standard, March 2010, vol./is. 24/26(42-7), 0029-6570 (2010 3 Mar) Author(s): McWilliams, D Abstract: Causes, effects on quality of life, and treatment options available for functional bowel disorders such as faecal incontinence, evacuatory disorders, and constipation. The use 13 of biofeedback as a conservative treatment is explored, and the indications and risk factors for rectal irrigation are discussed. 31 refs. Title: Health-related quality of life and symptom classification in patients with irritable bowel syndrome. Citation: J Nursing & Healthcare of Chronic Illness, March 2010, vol./is. 2/1(4-12), 17529816 (2010 Mar) Author(s): Smith, G, Steinke, D, Penny, K Abstract: Quantitative research examining the impact of irritable bowel syndrome (IBS) on patients' health-related quality of life (HRQol). Factors associated with poor HRQol among the community-based participants, who were classified into 3 sub-types according to the predominance of diarrhoea, constipation or mixed symptoms, are discussed. 43 refs. Title: Bowel problems and coping strategies in people with multiple sclerosis. Citation: Br J Nursing, February 2010, vol./is. 19/4(220-6), 0966-0461 (2010 25 Feb) Author(s): Norton, C, Chelvanayagam, S Abstract: Research among members of the Multiple Sclerosis (MS) Society into the effects of MS on bowel function. Questionnaire responses concerning the management of faecal incontinence and constipation, together with their impact on quality of life are discussed. 20 refs. Title: A systematic literature review of incontinence care for persons with dementia: the research evidence. Citation: J Clinical Nursing, February 2010, vol./is. 19/3-4(303-12), 0962-1067 (2010 Feb) Author(s): Hagglund, D Abstract: Systematic review of research examining the effectiveness of strategies used to assess, manage and prevent urinary/faecal incontinence in people with dementia. The impact of various management/prevention methods, including prompted/timed voiding, bladder/bowel/pelvic floor muscle training, incontinence aids, catheterisation and laxative use, was investigated. Challenges of maintaining dignity are considered. 54 refs. Title: Bowel care for patients with long-term chronic conditions. Citation: Continence UK, December 2009, vol./is. 3/4(22-9), 1753-8890 (2009 Dec) Author(s): Foxley, S, Latham, J Abstract: The nursing management of constipation in patients with long-term conditions. Normal bowel function is described and functional or anatomical problems which may cause constipation are outlined. Treatment options including lifestyle, exercise, diet and fluid intake, medication, surgery and a bowel management programme are discussed. 39 refs Title: Solitary rectal ulcer syndrome: physiology and treatment options. Citation: Br J Nursing, November 2009, vol./is. 18/21(1312-5), 0966-0461 (2009 26 Nov) Author(s): Swatton, A Abstract: The causes and management of solitary rectal ulcer syndrome. Diagnosis and association with constipation problems are described and treatment options including medication, biofeedback therapy involving a nurse specialist and surgical procedures are outlined and illustrated. 27 refs. Title: The cost of containment. Citation: Nursing Older People, April 2008, vol./is. 20/3(24-6), 1472-0795 Author(s): Davis, C 14 Abstract: Discussion of the report 'National Audit of Continence Care for Older People' by the Royal College of Physicians of London (2008). Failures to comply with NICE guidelines for continence care including history taking, checking for infection and treatment such as pelvic floor exercises are highlighted. The consequences for patient dignity, psychosocial effects, depression and moving to long term care are emphasised. 8 refs 15