The Conservative Therapy for Fecal Continence

便失禁の保存的治療では，まず患者の生活習慣を調べた上で食物繊維摂取を促し，便を軟化させるコーヒーやアルコールなどは控えるよう指導する．これに加え薬物療法が選択されるが，軟便が漏れる場合はロペラミドが有効とされ，一方ポリカルボフィルカルシウムは便の性状に関係なく便失禁を改善させる．これら基本的なアプローチで改善しない場合，より専門的な介入の適応となる．便失禁に対するバイオフィードバック療法（以下BF療法）は症状の改善に有用で，海外では広く認められた方法である．当院では薬物療法で改善しなかった54名にBF療法を施行し，Wexner's scoreを9から3へ改善させることができた．他にアナルプラグや逆行性洗腸があるが，いずれも脊髄障害患者や直腸切除後といった特定の対象者で有効性が得られている．

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