Medical Treatment of Fecal Incontinence

  • Carlo Ratto
  • Angelo Parello
  • Lorenza Donisi
  • Francesco Litta
  • Giovanni B. Doglietto


Management of fecal incontinence (FI) should be based on a meticulous assessment of pathophysiology through both clinical and physiological diagnostic workup. There are cases with prevalently altered diet and hygiene. Very frequently, diarrhea and constipation can be found involved in the development and maintenance of FI [1-3], both in the presence or absence of other traumatic or nontraumatic causes. Consequently, in those cases, treatment must be directed toward cure of these dysfunctions, either as single-line or combined treatment. Little evidence exists in the available literature about medical therapy for FI; recently, a Cochrane Database Review high-lighted that “there is little evidence with which to assess the use of drug therapies for the management of fecal incontinence” [4]. Therefore, medical treatment in FI is debatable and often pragmatic.


Irritable Bowel Syndrome Chronic Diarrhea Imperforate Anus Celiac Sprue Intestinal Peristalsis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Nelson R, Furner S, Jesudason V (1998) Fecal incontinence in Wisconsin nursing homes: prevalence and associations. Dis Colon Rectum 41:1226–1229PubMedCrossRefGoogle Scholar
  2. 2.
    Chassagne P, Landrin I, Neveu C et al (1999) Fecal incontinence in the institutionalized elderly: incidence, risk factors, and prognosis. Am J Med 106:185–190PubMedCrossRefGoogle Scholar
  3. 3.
    Levine MD (1975) Children with encopresis: A descriptive analysis. Pediatrics 56:412–416PubMedGoogle Scholar
  4. 4.
    Cheetham M, Brazzelli M, Norton C et al (2003) Drug treatment for fecal incontinence in adults. Cochrane Database Syst Rev 4:1–26Google Scholar
  5. 5.
    Goode PS, Burgio KL, Halli AD et al (2005) Prevalence and correlates of fecal incontinence in communitydwelling older adults. J Am Geriatr Soc 53:629–635PubMedCrossRefGoogle Scholar
  6. 6.
    Drossman DA (1989) What can be done to control incontinence associated with irritable bowel syndrome? Am J Gastroenterol 84:365–366Google Scholar
  7. 7.
    Olden KW (2002) Diagnosis of irritable bowel syndrome. Gastroenterology 122:1701–1714PubMedCrossRefGoogle Scholar
  8. 8.
    Lembo TJ, Fink RN (2002) Clinical assessment of irritable bowel syndrome. J Clin Gastroenterol 35:S31–S36PubMedCrossRefGoogle Scholar
  9. 9.
    Fine KD, Meyer RL, Lee EL (1997) The prevalence and causes of chronic diarrhea in patients with celiac sprue treated with a gluten-free diet Gastroenterology 112:1830–1838Google Scholar
  10. 10.
    Bliss DZ, Jung HJ, Savok K et al (2001) Supplementation with dietary fiber improves fecal incontinence. Nurs Res 50:203–213PubMedCrossRefGoogle Scholar
  11. 11.
    Palmer KR, Corbett CL, Holdsworth CD (1980) Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology 79:1272–1275PubMedGoogle Scholar
  12. 12.
    Read MG, Read NM, Duthie HL (1979) Effect of loperamide in anal sphincter function in patients with diarrhea. Gut 20:A942CrossRefGoogle Scholar
  13. 13.
    Bergman L, Djarv L (1981) A comparative study of loperamide and diphenoxylate in the treatment of chronic diarrhoea caused by intestinal resection. Ann Clin Res 13:402–405PubMedGoogle Scholar
  14. 14.
    Read M, Read NW, Barber DC et al (1982) Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Dig Dis Sci 27:807–814PubMedCrossRefGoogle Scholar
  15. 15.
    Hallgren T, Fasth S, Delbro DS et al (1994) Loperamide improves anal sphincter function and continence after restorative proctocolectomy. Dig Dis Sci 39:2612–2618PubMedCrossRefGoogle Scholar
  16. 16.
    Arnbjornsson E, Breland U, Kullendorff CM et al (1986) Effect of loperamide on faecal control after rectoplasty for high imperforate anus. Acta Chir Scand 152:215–216PubMedGoogle Scholar
  17. 17.
    Carapeti EA, Kamm MA, Evans BK et al (1999) Topical phenylephrine increases anal sphincter resting pressure. Br J Surg 86:267–270PubMedCrossRefGoogle Scholar
  18. 18.
    Cheetham MJ, Kamm MA, Phillips RK (2001) Topical phenylephrine increases anal canal resting pressure in patients with faecal incontinence. Gut 48:356–359PubMedCrossRefGoogle Scholar
  19. 19.
    Ritchie JA, Truelove SC (1980) Comparison of various treatments for irritable bowel syndrome. Br Med J 281:1317–1319PubMedCrossRefGoogle Scholar
  20. 20.
    Farrar JT (1982) The effects of drugs on intestinal motility. Clin Gastroenterol 11:673–681PubMedGoogle Scholar
  21. 21.
    Santoro GA, Eitan BZ, Pryde A et al (2000) Open study of low-dose amitriptyline in the treatment of patients with idiopathic fecal incontinence. Dis Colon Rectum 43:1676–1681PubMedCrossRefGoogle Scholar
  22. 22.
    Chassagne P, Jego A, Gloc P et al (2000) Does treatment of constipation improve faecal incontinence in institutionalized elderly patients? Age Ageing 29:159–164PubMedCrossRefGoogle Scholar
  23. 23.
    Prather CM, Camilleri M, Zinsmeister AR et al (2000) Tegaserod accelerates orocecal transit in patients with constipation-predominant irritable bowel syndrome. Gastroenterology 118:463–468PubMedCrossRefGoogle Scholar
  24. 24.
    Tougas G, Snape WJ Jr, Otten MH et al (2002) Longterm safety of tegaserod in patients with constipationpredominant irritable bowel syndrome. Aliment Pharmacol Ther 16:1701–1708PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Carlo Ratto
  • Angelo Parello
  • Lorenza Donisi
  • Francesco Litta
  • Giovanni B. Doglietto

There are no affiliations available

Personalised recommendations