Risk Factors in Faecal Incontinence

  • S. Mark Scott
  • Peter J. Lunniss


Continence is a highly complex physiological function requiring coordinated activity of brain and central nervous system (CNS), autonomic and enteric nervous systems; a gastrointestinal tract of adequate length and biomechanical properties; and a competent anal sphincter complex, many components of which remain incompletely understood. In a minority of cases, for example incontinence immediately following fistulotomy for a high anal fistula in an otherwise “normal” individual, the cause-effect relationship is clear. For the majority, however, temporal relationships are not so evident, e.g. onset of symptoms several decades following a clinically uneventful vaginal delivery but one in which covert sphincter damage occurred, in which association between event and symptoms is less clear, and in which the event may be just one component of a multifactorial aetiology. Structural sphincteric causes of incontinence are relatively easy to investigate; at the most simplistic level, faecal continence depends upon anal pressure being higher than rectal pressure, and that this situation may be maintained predominantly by internal anal sphincter function, augmented at times of increased rectal pressure by voluntary anal muscle contraction, reflex or conscious, and orchestrated by intact sensation.


Irritable Bowel Syndrome Pelvic Floor Faecal Incontinence Anal Sphincter Rectal Prolapse 
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.


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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • S. Mark Scott
  • Peter J. Lunniss

There are no affiliations available

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