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General Reference

Nejm 2007;356:1648

Pathophys and Cause

Cause:Diarrhea; overflow from impactions (encopresis, see above); rectal neoplasms; neurologic, eg, myelomeningocele, MS, dementia, CVA, neuropathy, cord lesions; abnormal pelvic floor, eg, congenital and trauma, esp from ob, aging, and pelvic floor denervation

Epidemiology

Esp common in the elderly

Treatment

Rx:1st: high-fiber diet, loperamide (Imodium), diphenoxylate (Lomotil), enemas if impacted; 2nd: biofeedback; 3rd: surgery