Faecal incontinence in adults

The pathogenesis of faecal incontinence is often multifactorial with local, anatomical, or systemic disorders potentially contributing.

There is a significant response to conservative therapy and appropriate support.

For those who do not respond to conservative treatment, investigation by a consultant specialist is recommended to determine underlying aetiology.

Surgical options include anterior sphincter repair and neosphincter formation.

Faecal incontinence is the involuntary passage of flatus or faeces. The underlying aetiology is often complex with multiple possible contributing factors including anorectal structural abnormalities, neurological disorders, cognitive or behavioural dysfunction, stool consistency, or general disability (particularly age). Sometimes no cause can be found. It is extremely common, affecting up to 10% of adults, but the true prevalence remains hidden due to the associated stigma.[1]Perry S, Shaw C, McGrother C, et al. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut. 2002 Apr;50(4):480-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773171 http://www.ncbi.nlm.nih.gov/pubmed/11889066?tool=bestpractice.com [2]MacMillan AK, Merrie AE, Marshall RJ, et al. The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum. 2004 Aug;47(8):1341-9. http://www.ncbi.nlm.nih.gov/pubmed/15484348?tool=bestpractice.com