An Important Problem After Colorectal Cancer Surgery: Fecal Incontinence

Year 2020, Volume: 3 Issue: 1, 36 - 43, 30.04.2020

Dilek Aktaş , Sema Koçaşlı

https://doi.org/10.38108/ouhcd.712645

Cited By: 1

Abstract

With the increasing number
of patients diagnosed with colorectal cancer in recent years, the rate of
colorectal surgery is gradually increasing. Bowel dysfunction that occurs due
to cancer treatment causes to defecation problems.

The problem that we
frequently encounter after colorectal surgery is fecal incontinence.
Individuals who encounter this problem have a sense of stigma, shame, loss of
control, and anxiety related to reach the toilet. For this reason, individuals
are afraid to share their fecal incontinence with other individuals around them
and healthcare professionals. They move away from social environments. Moving
away from social environments, changes in lifestyle and psychological problems
negatively affect their quality of life. Therefore, the severity of fecal
incontinence should be determined and treated as soon as possible. Pelvic floor
exercises, biofeedback, electrical stimulation, dietary regulations and drug
treatments are recommended for the treatment of fecal incontinence.

The nurse plays a key role
in determining the high-risk patients and appropriate treatment options in this
case which associated with colorectal surgery. At the same time, nurses take an
actively involved in coping with physical-psychosocial problems, in the
regulation of lifestyle, and in the regulation of excretory habits of
individuals with fecal incontinence problems. It assumes the role of education,
counseling, and care of patients. Nurses play the role of education, counseling
and care of patients.

Keywords

Colorectal Cancer, Surgery, Fecal Incontinence, Nursing

Kolorektal Kanser Cerrahisi Sonrası Önemli Bir Sorun: Fekal İnkontinans

Abstract

Son yıllarda kolorektal kanser tanısı konan
hasta sayısının artması ile birlikte kolorektal cerrahi oranı da giderek
artmaktadır. Kanser tedavisine bağlı olarak ortaya çıkan bağırsak disfonksiyonu
bireylerin defekasyon sorunları ile karşı karşıya kalmasına neden olmaktadır.

Kolorektal cerrahi sonrası sıklıkla karşımıza
çıkan sorun fekal inkontinanstır. Bu sorunla karşılaşan bireyler damgalanma,
utanma, kontrol kaybı duygusu, tuvalete yetişememe endişesi taşımaktadır.  Bu nedenle de bireyler fekal inkontinas
yaşadığını çevresindeki diğer bireylerle ve sağlık profesyoneli ile
paylaşmaktan çekinmekte ve sosyal ortamlardan uzaklaşmaktadırlar. Sosyal
ortamlardan uzaklaşmak, yaşam tarzında meydana gelen değişiklikler ve
psikolojik sorunlar, bireylerin yaşam kalitesini olumsuz yönde etkilemektedir.
Bu nedenle fekal inkontinans şiddetinin en kısa sürede belirlenmesi ve tedavi
edilmesi gerekmektedir. Fekal inkontinans tedavisi için pelvik taban
egzersizleri, biyofeedback, elektrik stimulasyonu, diyet düzenlemeleri ve ilaç
tedavileri önerilmektedir.

Kolorektal cerrahiye bağlı olarak görülen bu
durumda yüksek risk grubundaki hastaların ve uygun tedavi seçeneklerinin
belirlenmesinde hemşire anahtar rol oynamaktadır. Aynı zamanda hemşireler fekal
inkontinans sorunu yaşayan hastaların fiziksel-psikososyal
sorunlar ile baş etmesinde, yaşam şeklinin düzenlenmesinde, boşaltım
alışkanlıklarının düzenlenmesinde aktif rol oynamaktadır. Hemşire hastaların
eğitim, danışmanlık, bakım rollerini üstlenmektedir. 

Keywords

kolorektal kanser, cerrahi, fekal inkontinans, hemşirelik

References

• Akbayrak T, Kaya S. (2016). Kadın Sağlığında Fizyoterapi ve Rehabilitasyon. 1. Baskı, Ankara, Kalkan Matbaacılık, s. 141-166.
• Bardsley A. (2013). Prevention and management of incontinence-associated dermatitis. Nursing Standard, 27(44). 41-46.
• Barisic G, Markovic V, Popovic M, Dimitrijevic I, Gavrilovic P, Krivokapic ZV. (2011). Function after intersphincteric resection for low rectal cancer and its influence on quality of life. Colorectal Disease, 13(6), 638–643.
• Beeckman D, Schoonhoven L, Verhaeghe S, Heyneman A, Defloor T. (2009). Prevention and treatment of incontinence‐associated dermatitis: literature review. Journal of Advanced Nursing, 65(6), 1141-1154.
• Cam C, Selcuk S, Asoglu MR., Tug N, Akdemir Y, Ay P, Karateke A. (2011). Validation of the Wexner scale in women with fecal incontinence in a Turkish population. International Urogynecology Journal, 22(11), 1375-1379.
• Camilleri‐Brennan J, Steele R JC. (2002). Prospective analysis of quality of life after reversal of a defunctioning loop ileostomy. Colorectal Disease, 4(3), 167-171.
• Cangöl E, Aslan E, Yalçın, Ö. (2013). Kadınlarda pelvik taban kas egzersizleri ve hemşirenin rolü. Hemşirelikte Eğitim ve Araştırma Dergisi, 10 (3), 49-56.
• Croswell E, Bliss DZ, Savik K. (2010). Diet and eating pattern modifications used by community-living adults to manage their fecal incontinence. J Wound Ostomy Continence Nurs, 37(6); 677-682.
• Dedeli Ö, Fadiloglu C, Bor S. (2009). Validity and reliability of a Turkish version of the Fecal Incontinence Quality of Life Scale. Journal of Wound Ostomy&Continence Nursing, 36(5), 532-538.
• Dedeli Ö, Pakyüz S.Ç. (2016). Bowel movement: the sixth vital sign?. Clinical and Experimental Health Sciences, 6(3), 135-139.
• Emmertsen K.J, Laurberg S. (2012). Low anterior resection syndrome score: Development and validation of a symptom‐based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Annals Surgery, 255( 5), 922– 928.
• Emmertsen K.J, Laurberg S, Jess P, Madsen M.R, Nielsen H.J, Ovesen A.U ve ark. (2013). Impact of bowel dysfunction on quality of life after sphincter‐preserving resection for rectal cancer. British Journal of Surgery, 100(10), 1377-1387.
• Elfeki H, Larsen H.M, Emmertsen K.J, Christensen P, Youssef M, Khafagy W ve ark. (2019). Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life. British Journal of Surgery, 106(1), 142-151.
• Erdil F, Elbaş NÖ. (2008). Cerrahi Hastalıkları Hemşireliği. 5. Baskı, Ankara, Aydoğdu Ofset Matbaacılık Ambalaj San. Tic Ltd. Şti.480-481.
• Fish D, Temple LK. (2014). Functional consequences of colorectal cancer management. Surgical Oncology Clinics of North America, 23, 127–149.
• Güzelant A, Göksel T, Özkok S. (2004). The European Organization for Research and Treatment of Cancer QLQ-30: An examination into the cultural validity and reliability of Turkish version of the EORTC QLQ-30. European Journal of Cancer Care, 13, 135-144.
• Gump K, Schmelzer M. (2016). Gaining control over fecal incontinence. Medsurg Nursing, 25(2), 97-102.
• Hansen JL, Bliss DZ, Peden-McAlpine C. (2006). Diet strategies used by women to manage fecal incontinence. J Wound Ostomy Continence Nurs, 33(1), 52–61.
• Hayden D.M, Weiss E.G. (2011). Fecal incontinence: etiology, evaluation, and treatment. Clinics in Colon and Rectal Surgery, 24(1), 64-70.
• Heymen S, Scarlett Y, Jones K, Ringel Y, Drossman D, Whitehead WE. (2009). Randomized controlled trial shows biofeedback to be superior to pelvic floor exercises for fecal incontinence. Diseases of the Colon & Rectum, 52(10), 1730-1737.
• Hirano A, Koda K, Kosugi C, Kasugi C, Yamazaki M, Yasuda H. (2011). Damage to anal sphincter/levator ani muscles caused by operative procedure in anal sphincter‐preserving operation for rectal cancer. The American Journal of Surgery, 201(4), 508– 513.
• Huang YJ, Lin SE, Wei PL, Hung CS, Kuo LJ. (2011). Histopathologic analysis of the anal sphincter after chemoradiation for low rectal cancer. Journal of Experimental & Clinical Medicine, 3 (6): 296-269.
• Jeong H, Park J. (2019). Factors influencing changing bowel habits in patients undergoing sphincter‐saving surgery for rectal cancer. International Wound Journal, 16(1), 71-75.
• Koda K, Yasuda H, Hirano A, Kosugi C, Suzuki M, Yamazaki M ve ark. (2009). Evaluation of postoperative damage to anal sphincter/levator ani muscles with three‐dimensional vector manometry after sphincter‐preserving operation for rectal cancer. Journel of the American College Surgeons, 208(3), 362-367.
• Landers M, Savage E, McCarthy G, Fitzpatrick JJ. (2011). Self‐care strategies for the management of bowel symptoms following sphincter‐saving surgery for rectal cancer. Clinical Journal of Oncology Nursing, 15( 6), E105‐ E113.
• Landers M, McCarthy G, Savage E. (2012). Bowel symptom experiences and management following sphincter saving surgery for rectal cancer: a qualitative perspective. European Journal of Oncology Nursing, 16(3), 293-300.
• Landers M, McCarthy G, Livingstone V, Savage E. (2014). Patients’ bowel symptom experiences and self‐care strategies following sphincter‐saving surgery for rectal cancer. Journal of Clinical Nursing, 23(15-16), 2343-2354.
• Lange MM, Den Dulk M, Bossema ER, Maas C.P, Peeter K.C.M.J., Rutten H.J ve ark. (2007). Risk factors for faecal incontinence after rectal cancer treatment. British Journal of Surgery, 94( 10), 1278‐ 1284.
• Lin Y.H, Yang H.Y, Hung S.L, Chen, H.P, Liu, K.W, Chen, T. B, Chi S.C. (2016). Effects of pelvic floor muscle exercise on faecal incontinence in rectal cancer patients after stoma closure. European Journal Of Cancer Care, 25(3), 449-457.
• Lundby L, Duelund-Jakobsen J. (2011). Management of fecal incontinence after treatment for rectal cancer. Current opinion in supportive and palliative care, 5(1), 60-64. Moore K.H. (2013). Urogynecology: Evidence-Based Clinical Practice. 2. Baskı, London, Springer Science & Business Media, 81-82.
• Ness W. (2012). Faecal incontinence: causes, assessment and management. Nursing Standard, 26(42). 52-60.
• Nikoletti S, Young J, Levitt M, King M, Chidlow C, Hollingsworth S. (2008). Bowel problems, self‐care practices, and information needs of colorectal cancer survivors at 6 to 24 months after sphincter‐saving surgery. Cancer Nursing, 31(5), 389–398.
• Patel K, Bliss D.Z, Savik K. (2010). Health literacy and emotional responses related to fecal incontinence. Journal of Wound Ostomy Continence Nursing, 37(1), 73-79.
• Pınar R. (2005). Reliability and construct validity of the SF-36 in Turkish cancer patients. Quality of Life Research, 14(1), 259-264.
• Santoro G.A, Wieczorek A.P, Bartram C.I. (2010). Pelvic Floor Disorders Imaging and Multidisciplinary Approach to Management, Italy, Springer Science & Business Media.
• Siassi M, Hohenberger W, Lösel F, Weiss M. (2008). Quality of life and patient’s expectations after closure of a temporary stoma. International Journal of Colorectal Disease, 23(12), 1207-1212.
• Simpson M.F, Whyte F. (2006). Adjustment to colostomy: stoma acceptance stoma care and self-efficacy and interpersonal relationships. Journal of Advanced Nursing, 60(6), 627-635.
• Sun V, Grant M, Wendel C.S, McMullen C.K, Bulkley J.E, Altschuler A ve ark. (2015). Dietary and behavioral adjustments to manage bowel dysfunction after surgery in long-term colorectal cancer survivors. Annals of Surgical Oncology, 22(13), 4317-4324.
• Tan S.H, Liao Y.M, Lee K.C, Ko Y.L, Lin P.C. (2019). Exploring bowel dysfunction of patients following colorectal surgery: A cohort study. Journal of Clinical Nursing, 28(9-10), 1577-1584.
• Taylor C, Morgan L. (2011). Quality of life after reversal of temporary stoma after rectal cancer treatment. European Journal of Oncology Nursing, 15 (1), 59-66.
• Timmermans S.L. (2016). Eliciting help-seeking behaviors in patients with fecal incontinence: Supporting timely access to treatment. Home healthcare now, 34(8), 424-433.
• T.C. Sağlık Bakanlığı (2019). Sağlık İstatistikleri Yıllığı 2018. Ankara, Türkiye Cumhuriyeti Sağlık Bakanlığı Sağlık Bilgi Sistemleri Genel Müdürlüğü.
• T.C. Sağlık Bakanlığı (2018).Türkiye Halk Sağlığı Genel Müdürlüğü Türkiye Kanser Kontrol Programı, Ankara, T.C. Sağlık Bakanlığı.
• Wallner C, Lange M.M, Bonsing B.A, Maas C.P, Wallace C.N, Dabhoiwala N.F ve ark. (2008). Causes of fecal and urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery: a study from the Cooperative Clinical Investigators of the Dutch total mesorectal excision trial. Journal of Clinical Oncology, 26(27), 4466-4472.
• Wang JY, Abbas MA. (2013). Current management of fecal ıncontinence. The Permanente Journal. 17(3), 65-73.
• WHO (2018). Cancer. Cancer 12.09.2018 Erişim Tarihi: 12.03.2020, Erişim Adresi: https://www.who.int/ news-room/fact-sheets/detail/cancer
• Yılmaz B, Aslan E. (2018). Fekal inkontinans ve hemşirelik yaklaşımı. SDÜ Sağlık Bilimleri Dergisi, 9(3), 39-44.
• Yin L, Fan L, Tan R, Yang G, Jiang F, Zhang C ve ark. (2018). Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer. BMC Surgery, 18(1), 1-6.