Office-based management of fecal incontinence

Vanessa C. Costilla, Amy E. Foxx-Orenstein, Anita P. Mayer, Michael D. Crowell

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Fecal incontinence (FI) is a devastating disorder that is more prevalent than previously realized. FI is the involuntary loss of stool. Many factors contribute to the pathophysiology of FI, including advanced age, bowel irregularity, parity, and obesity. A detailed history and focused rectal examination are important to making the diagnosis and determining contributing causes. Although multiple diagnostic studies are available to assess the cause of FI, specific guidelines that delineate when testing should be done do not exist. Clinicians must weigh the risk, benefit, and burden of testing against the need for empiric treatment. All types of FI are initially managed in the same way, which includes lifestyle modification to reduce bowel derangements, improved access to toileting, and initiation of a bulking regimen to improve stool consistency. If initial conservative management fails, pharmacologic agents, biofeedback, or surgery may be indicated.

Original languageEnglish (US)
Pages (from-to)423-433
Number of pages11
JournalGastroenterology and Hepatology
Volume9
Issue number7
StatePublished - Jul 1 2013

Keywords

  • Anal incontinence
  • Bariatric surgery incontinence
  • Fecal incontinence
  • Fecal seepage
  • Flatal incontinence
  • Obesity incontinence

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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