Treatment of fecal incontinence

Lee, Kwang Jae

Abstract

Fecal incontinence is defined as either the involuntary passage of gas or stool or the inability to control the passage of fecal contents through the anus. Patients are reluctant to report fecal incontinence, resulting in underestimated prevalence. Studies have reported that its prevalence ranges from 2% to 20%. Diverse causes are involved in the generation of fecal incontinence. Fecal incontinence leads to a loss of self-esteem, social isolation, and a diminished quality of life. Antidiarrheals are useful for diarrhea with incontinence. Biofeedback therapy and exercise therapies may be helpful, particularly in patients with weak sphincters and/or impaired rectal sensation. Sacral nerve stimulation can be an option if other treatments have not been successful. Although some studies have shown the efficacy of injectable bulking agents, data on their long-term outcome and experience are lacking. Sphincteroplasty can be considered in selected patients who have failed nonsurgical measures or biofeedback therapy. A colostomy is a less preferable option. The various treatment options can be chosen with an individualized approach, depending on the causes of fecal incontinence, the action mechanism of treatment, comorbidities, general condition, and procedure-related risks.