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Index & contispation
Defecation Norm Gram
Continence Norm Gram
Applications of the Theory
Facts and Controversies
Curves were calculated and subsequently plotted on the norm
Sulphate Continence Curve (Upper solid curve)
Continence Curve (middle solid curve)
Sulphate Soiling Curve (Upper dashed curve)
Soiling Curve (lower dashed Curve)
Continence Curve (Lower Solid Curve)
above mentioned curves divide the norm gram into 6 Zones forming
the basis of a new functional classification of the degree of
severity of fecal incontinence as:
Grade I: Continent , anal staining
due to minor anal problem(e.g. Hemorrhoids), and incontinence
on top of normal anal Sphincter (e.g. fecal impaction).
grade from II - VI is assigned with Letters P, S or U (as an
indication for passive, stress or urgency anal incontinence
respectively) in order to signify which measurements are to
be used in calculation of Flow Index or in the Norm grams.
each patient on the norm gram is done in the same way as in
defecation Norm gram (vide supra).
between mathematical Anal incontinence despite absence of clinical
incontinence is considered as sub-clinical sphincter weakness
which may be unmasked later on. E.g. a patient with sub-clinical
gas incontinence may be masked by minimal amount of bowel gas
produced in his bowel. Similarly a patient with mathematical
stress fluid incontinence my be apparently normal because he
has to have watery diarrhea simultaneously with an attack of
chest infection to start to have clinical incontinence.