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Risk Factors in Faecal Incontinence

  • Chapter
Fecal Incontinence

Abstract

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.

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Authors
  1. S. Mark Scott
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  2. Peter J. Lunniss
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Editors and Affiliations

  1. Department of Surgical Sciences Division of Digestive Surgery, Catholic University, Rome, Italy

    Carlo Ratto  & Giovanni B. Doglietto  & 

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Scott, S.M., Lunniss, P.J. (2007). Risk Factors in Faecal Incontinence. In: Ratto, C., Doglietto, G.B., Lowry, A.C., Påhlman, L., Romano, G. (eds) Fecal Incontinence. Springer, Milano. https://doi.org/10.1007/978-88-470-0638-6_4

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  • DOI: https://doi.org/10.1007/978-88-470-0638-6_4

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0637-9

  • Online ISBN: 978-88-470-0638-6

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