Fecal Incontinence

Abstract

Fecal incontinence (FI) is a frequently occcurring, distressing condition that has a devastating impact on the lives of patients. However, patients are typically embarrassed and reluctant to acknowledge this disability, so they do not seek a cure and remain socially isolated. The exact incidence of FI is not known, because of the reluctance of patients to seek help from their physicians. Most epidemiological studies suggest a prevalence of as high as 2% of the general population; however, when patient interviews ask specific questions about FI, the rate is usually significantly higher. Women seem to be at higher risk of FI, mostly because of obstetric damage to anal sphincters; however, during the last decade there has been increasing interest in types of FI with nontraumatic causes, as these have been shown to occur in significant numbers. Older subjects are at a very high risk of FI, especially those that present with disabilities or are institutionalized. Young patients are also often affected. This results in a significant economic impact for society because of the direct and indirect costs, and also for intangible reasons. Since FI can be the result of various pathophysiological conditions, and a variety of risk factors can cause a wide range of ways in which patients develop the inability to control the passage of feces, an accurate diagnostic work-up of each patient is fundamental.