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Evaluation and Treatment of FI

  • Ian M. Paquette
  • Liliana BordeianouEmail author
Chapter

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.

Keywords

Fecal incontinence Accidental bowel leakage Sphincteroplasty Sacral neuromodulation Biomaterial injection Radiofrequency energy delivery Artificial bowel sphincter 

Supplementary material

Video 61.1

Sphincteroplasty (MP4 29071 kb)

Video 61.2

Sacral nerve modulation (MP4 28791 kb)

Video 61.3

Magnetic anal sphincter (MP4 18350 kb)

Copyright information

© ASCRS (American Society of Colon and Rectal Surgeons) 2019

Authors and Affiliations

  1. 1.Department of Surgery, Division of Colon and Rectal SurgeryUniversity of Cincinnati Medical CenterCincinnatiUSA
  2. 2.Department of General SurgeryMassachusetts General HospitalBostonUSA

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