Evaluation and Treatment of FI

Abstract

Fecal incontinence (FI) is a common condition, affecting nearly 10% of women over age 45 at least once per month. A thorough history of precipitating factors, obstetric history, and prior surgical history are important components of the workup of FI. Once the diagnosis has been established, management should begin with conservative measures including fiber supplements or antimotility agents, elimination of precipitating foods and medications, and consideration of biofeedback. When surgical treatment is necessary, sphincteroplasty is still the mainstay of treatment for young patients with a complete sphincter defect. Recently several other treatments have emerged including sacral neuromodulation, biomaterial injection, radiofrequency energy delivery, artificial bowel sphincter, and the magnetic sphincter. This chapter will compare the efficacy of these techniques and offer a treatment algorithm for patients with FI.