Fecal incontinence in adults

References

Key articles

National Institute for Health and Care Excellence. Faecal incontinence in adults: management. Jun 2007 [internet publication].Full text

Bordeianou LG​, Thorsen AJ, Keller DS, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of fecal incontinence. Diseases of the Colon & Rectum. 2023 May;66(5):647-61.Full text

Arasaradnam RP, Brown S, Forbes A, et al. Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition. Gut. 2018 Aug;67(8):1380-99.Full text  Abstract

Thaha MA, Abukar AA, Thin NN, et al. Sacral nerve stimulation for faecal incontinence and constipation in adults. Cochrane Database Syst Rev. 2015 Aug 24;(8):CD004464.Full text  Abstract

Reference articles

1. Perry S, Shaw C, McGrother C, et al; Leicestershire MRC Incontinence Study Team. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut. 2002 Apr;50(4):480-4.Full text  Abstract

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. Abstract

3. Nelson R, Norton N, Cautley E, et al. Community-based prevalence of anal incontinence. JAMA. 1995 Aug 16;274(7):559-61. Abstract

4. Ribas Y, Coll M, Espina A, et al. Initiative to improve detection of faecal incontinence in primary care: the GIFT Project. Fam Pract. 2017 Apr 1;34(2):175-9.Full text  Abstract

5. Sharma A, Yuan L, Marshall RJ, et al. Systematic review of the prevalence of faecal incontinence. Br J Surg. 2016 Nov;103(12):1589-97. Abstract

6. Nelson RL. Epidemiology of fecal incontinence. Gastroenterology. 2004 Jan;126(1 Suppl 1):S3-7. Abstract

7. Xu X, Menees SB, Zochowski MK, et al. Economic cost of fecal incontinence. Dis Colon Rectum. 2012 May;55(5):586-98. Abstract

8. National Institute for Health and Care Excellence. Faecal incontinence in adults: management. Jun 2007 [internet publication].Full text

9. Norton C, Whitehead WE, Bliss DZ, et al; Conservative Management of Fecal Incontinence in Adults Committee of the International Consultation on Incontinence. Management of fecal incontinence in adults. Neurourol Urodyn. 2010;29(1):199-206.Full text  Abstract

10. Wyndaele JJ, Kovindha A, Igawa Y, et al. Neurologic fecal incontinence. Neurourol Urodyn. 2010;29(1):207-12. Abstract

11. Schiller LR, Santa Ana CA, Schmulen AC, et al. Pathogenesis of fecal incontinence in diabetes mellitus: evidence for internal-anal-sphincter dysfunction. N Engl J Med. 1982 Dec 30;307(27):1666-71. Abstract

12. Dudding TC, Vaizey CJ, Kamm MA. Obstetric anal sphincter injury: incidence, risk factors, and management. Ann Surg. 2008 Feb;247(2):224-37. Abstract

13. Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin No. 198: prevention and management of obstetric lacerations at vaginal delivery. Obstet Gynecol. 2018 Sep;132(3):e87-e102.Full text  Abstract

14. Hayden DM, Weiss EG. Fecal incontinence: etiology, evaluation, and treatment. Clin Colon Rectal Surg. 2011 Mar;24(1):64-70.Full text  Abstract

15. Rao SS. Pathophysiology of adult fecal incontinence. Gastroenterology. 2004 Jan;126(1 suppl 1):S14-22.Full text  Abstract

16. Madoff RD, Parker SC, Varma MG, et al. Faecal incontinence in adults. Lancet. 2004 Aug 14-20;364(9434):621-32. Abstract

17. Drossman DA. What can be done to control incontinence associated with the irritable bowel syndrome? Am J Gastroenterol. 1989 Apr;84(4):355-7. Abstract

18. Pergialiotis V, Vlachos D, Protopapas A, et al. Risk factors for severe perineal lacerations during childbirth. Int J Gynaecol Obstet. 2014 Apr;125(1):6-14.Full text  Abstract

19. Evers EC, Blomquist JL, McDermott KC, et al. Obstetrical anal sphincter laceration and anal incontinence 5-10 years after childbirth. Am J Obstet Gynecol. 2012 Nov;207(5):425.e1-6.Full text  Abstract

20. Fenner DE, Genberg B, Brahma P, et al. Fecal and urinary incontinence after vaginal delivery with anal sphincter disruption in an obstetrics unit in the United States. Am J Obstet Gynecol. 2003 Dec;189(6):1543-9; discussion 1549-50.Full text  Abstract

21. LaCross A, Groff M, Smaldone A. Obstetric anal sphincter injury and anal incontinence following vaginal birth: a systematic review and meta-analysis. J Midwifery Womens Health. 2015 Jan-Feb;60(1):37-47. Abstract

22. Pfeifer J, Agachan F, Oliveira L, et al. Clinical significance of the rectoanal inhibitory reflex in patients with rectal prolapse. Tech Coloproctol. 1996;4:122-4.

23. Coggrave M, Norton C, Cody JD. Management of faecal incontinence and constipation in adults with central neurological diseases. Cochrane Database Syst Rev. 2014 Jan 13;(1):CD002115.Full text  Abstract

24. Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020 May 6;(5):CD007471.Full text  Abstract

25. Landefeld CS, Bowers BJ, Feld AD, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008 Mar 18;148(6):449-58.Full text  Abstract

26. Bordeianou LG​, Thorsen AJ, Keller DS, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of fecal incontinence. Diseases of the Colon & Rectum. 2023 May;66(5):647-61.Full text

27. American College of Obstetricians and Gynecologists. Practice bulletin no. 210: fecal incontinence. Apr 2019 [internet publication].Full text

28. Baxter NN, Rothenberger DA, Lowry AC. Measuring fecal incontinence. Dis Colon Rectum. 2003 Dec;46(12):1591-605. Abstract

29. Vaizey CJ, Carapeti E, Cahill JA, et al. Prospective comparison of faecal incontinence grading systems. Gut. 1999 Jan;44(1):77-80.Full text  Abstract

30. Arasaradnam RP, Brown S, Forbes A, et al. Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition. Gut. 2018 Aug;67(8):1380-99.Full text  Abstract

31. Jorge JM, Wexner SD. Anorectal manometry: techniques and clinical applications. South Med J. 1993 Aug;86(8):924-31. Abstract

32. Sultan AH, Kamm MA, Talbot IC, et al. Anal endosonography for identifying external sphincter defects confirmed histologically. Br J Surg. 1994 Mar;81(3):463-5. Abstract

33. Abdool Z, Sultan AH, Thakar R. Ultrasound imaging of the anal sphincter complex: a review. Br J Radiol. 2012 Jul;85(1015):865-75.Full text  Abstract

34. Carrington EV, Scott SM, Bharucha A, et al; International Anorectal Physiology Working Group and the International Working Group for Disorders of Gastrointestinal Motility and Function. Expert consensus document: advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol. 2018 May;15(5):309-23.Full text  Abstract

35. Terra MP, Deutekom M, Beets-Tan RG, et al. Relationship between external anal sphincter atrophy at endoanal magnetic resonance imaging and clinical, functional, and anatomic characteristics in patients with fecal incontinence. Dis Colon Rectum. 2006 May;49(5):668-78. Abstract

36. Tan E, Anstee A, Koh DM, et al. Diagnostic precision of endoanal MRI in the detection of anal sphincter pathology: a meta-analysis. Int J Colorectal Dis. 2008 Jun;23(6):641-51. Abstract

37. Sajid MS, Khatri K, Siddiqui MR, et al. Endo-anal ultrasound versus endo-anal magnetic resonance imaging for the depiction of external anal sphincter pathology in patients with faecal incontinence: a systematic review. Magy Seb. 2010 Feb;63(1):9-15. Abstract

38. Wexner SD, Marchetti F, Jagelman DG. The role of sphincteroplasty for fecal incontinence reevaluated: a prospective physiologic and functional review. Dis Colon Rectum. 1991 Jan;34(1):22-30. Abstract

39. Jacobs PP, Scheuer M, Kuijpers JH. Obstetric fecal incontinence. Role of pelvic floor denervation and results of delayed sphincter repair. Dis Colon Rectum. 1990 Jun;33(6):494-7. Abstract

40. Sangwan YP, Coller JA, Barrett RC, et al. Unilateral pudendal neuropathy. Impact on outcome of anal sphincter repair. Dis Colon Rectum. 1996 Jun;39(6):686-9. Abstract

41. Frenckner B, Euler C. Influence of pudendal block on the function of the anal sphincters. Gut. 1975 Jun;16(6):482-9.Full text  Abstract

42. Rosier PF, Hosker GL, Szabó L, et al. Executive summary: The International Consultation on Incontinence 2008 Committee on: "Dynamic Testing" for urinary or fecal incontinence. Part 3: Anorectal physiology studies. Neurourol Urodyn. 2010;29(1):153-8.Full text  Abstract

43. Agency for Healthcare Research and Quality. Comparative effectiveness review number 165: treatments for fecal incontinence. Mar 2021 [internet publication].Full text

44. Bliss DZ, Savik K, Jung HJ, et al. Dietary fiber supplementation for fecal incontinence: a randomized clinical trial. Res Nurs Health. 2014 Oct;37(5):367-78. Abstract

45. Bliss DZ, Jung HJ, Savik K, et al. Supplementation of dietary fiber improves fecal incontinence. Nurs Res. 2001 Jul-Aug;50(4):203-13. Abstract

46. Fader M, Cottenden AM, Getliffe K. Absorbent products for moderate-heavy urinary and/or faecal incontinence in women and men. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD007408.Full text  Abstract

47. Deutekom M, Dobben A. Plugs for containing faecal incontinence. Cochrane Database Syst Rev. 2015 Jul 20;(7):CD005086.Full text  Abstract

48. Read M, Read NW, Barber DC, et al. Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Dig Dis Sci. 1982 Sep;27(9):807-14. Abstract

49. Santoro GA, Eitan BZ, Pryde A, et al. Open study of low-dose amitriptyline in the treatment of patients with idiopathic fecal incontinence. Dis Colon Rectum. 2000 Dec;43(12):1676-81. Abstract

50. Ehrenpreis ED, Chang D, Eichenwald E. Pharmacotherapy for fecal incontinence: a review. Dis Colon Rectum. 2007 May;50(5):641-9. Abstract

51. Tobin GW, Brocklehurst JC. Faecal incontinence in residential homes for the elderly: prevalence, aetiology and management. Age Ageing. 1986 Jan;15(1):41-6. Abstract

52. King JC, Currie DM, Wright E. Bowel training in spina bifida: importance of education, patient compliance, age and anal reflexes. Arch Phys Med Rehabil. 1994 Mar;75(3):243-7. Abstract

53. Tod AM, Stringer E, Levery C, et al. Rectal irrigation in the management of functional bowel disorders: a review. Br J Nurs. 2007 Jul 26-Aug 8;16(14):858-64. Abstract

54. Christensen P, Bazzocchi G, Coggrave M, et al. A randomized, controlled trial of transanal irrigation versus conservative bowel management in spinal cord-injured patients. Gastroenterology. 2006 Sep;131(3):738-47. Abstract

55. Matzel KE. Sacral nerve stimulation for faecal incontinence: its role in the treatment algorithm. Colorectal Dis. 2011 Mar;13(suppl 2):10-4. Abstract

56. Hetzer FH. Fifteen years of sacral nerve stimulation: from an open procedure to a minimally invasive technique. Colorectal Dis. 2011 Mar;13(suppl 2):1-4. Abstract

57. Dudding TC, Hollingshead JR, Nicholls RJ, et al. Sacral nerve stimulation for faecal incontinence: patient selection, service provision and operative technique. Colorectal Dis. 2011 Aug;13(8):e187-95. Abstract

58. Dudding TC, Hollingshead JR, Nicholls RJ, et al. Sacral nerve stimulation for faecal incontinence: optimizing outcome and managing complications. Colorectal Dis. 2011 Aug;13(8):e196-202. Abstract

59. Duelund-Jakobsen J, Buntzen S, Lundby L, et al. Sacral nerve stimulation at subsensory threshold does not compromise treatment efficacy: results from a randomized, blinded crossover study. Ann Surg. 2013 Feb;257(2):219-23. Abstract

60. Jarrett ME, Mowatt G, Glazener CM, et al. Systematic review of sacral nerve stimulation for faecal incontinence and constipation. Br J Surg. 2004 Dec;91(12):1559-69. Abstract

61. Thaha MA, Abukar AA, Thin NN, et al. Sacral nerve stimulation for faecal incontinence and constipation in adults. Cochrane Database Syst Rev. 2015 Aug 24;(8):CD004464.Full text  Abstract

62. O'Brien PE, Dixon JB, Skinner S, et al. A prospective, randomized, controlled clinical trial of placement of the artificial bowel sphincter (Acticon Neosphincter) for the control of fecal incontinence. Dis Colon Rectum. 2004 Nov;47(11):1852-60. Abstract

63. Niriella DA, Deen KI. Neosphincters in the management of faecal incontinence. Br J Surg. 2000 Dec;87(12):1617-28. Abstract

64. Tillin T, Chambers M, Feldman R. Outcomes of electrically stimulated gracilis neosphincter surgery. Health Technol Assess. 2005 Jul;9(28):1-102.Full text  Abstract

65. Wong WD, Congliosi SM, Spencer MP, et al. The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study. Dis Colon Rectum. 2002 Sep;45(9):1139-53. Abstract

66. Chatoor DR, Taylor SJ, Cohen CR, et al. Faecal incontinence. Br J Surg. 2007 Feb;94(2):134-44. Abstract

67. Norton CC, Cody JD. Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Cochrane Database Syst Rev. 2012 Jul 11;(7):CD002111.Full text  Abstract

68. Davis KJ, Kumar D, Poloniecki J. Adjuvant biofeedback following anal sphincter repair: a randomized study. Aliment Pharmacol Ther. 2004 Sep 1;20(5):539-49. Abstract

69. Bravo Gutierrez A, Madoff RD, Lowry AC, et al. Long-term results of anterior sphincteroplasty. Dis Colon Rectum. 2004 May;47(5):727-31. Abstract

70. Cook TA, Mortensen NJ. Management of faecal incontinence following obstetric injury. Br J Surg. 1998 Mar;85(3):293-9. Abstract

71. Malouf AJ, Norton CS, Engel AF, et al. Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet. 2000 Jan 22;355(9200):260-5. Abstract

72. Zorcolo L, Covotta L, Bartolo DC. Outcome of anterior sphincter repair for obstetric injury: comparison of early and late results. Dis Colon Rectum. 2005 Mar;48(3):524-31. Abstract

73. Draganic B, Eyers AA, Solomon MJ. Island flap perineoplasty decreases the incidence of wound breakdown following overlapping anterior sphincter repair. Colorectal Dis. 2001 Nov;3(6):387-91. Abstract

74. Rao SS, Benninga MA, Bharucha AE, et al. ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders. Neurogastroenterol Motil. 2015 May;27(5):594-609.Full text  Abstract

75. Watson NF, Koshy A, Sagar PM. Anal bulking agents for faecal incontinence. Colorectal Dis. 2012 Dec;14(suppl 3):29-33.Full text  Abstract

76. Graf W, Mellgren A, Matzel KE, et al. Efficacy of dextranomer in stabilised hyaluronic acid for treatment of faecal incontinence: a randomised, sham-controlled trial. Lancet. 2011 Mar 19;377(9770):997-1003. Abstract

77. Hoy SM. Dextranomer in stabilized sodium hyaluronate (Solesta): In adults with faecal incontinence. Drugs. 2012 Aug 20;72(12):1671-8. Abstract

78. Ratto C, Donisi L, Litta F, et al. Implantation of SphinKeeper(TM): a new artificial anal sphincter. Tech Coloproctol. 2016 Jan;20(1):59-66.Full text  Abstract

79. Malouf AJ, Vaizey CJ, Norton CS, et al. Internal anal sphincter augmentation for fecal incontinence using injectable silicone biomaterial. Dis Colon Rectum. 2001 Apr;44(4):595-600. Abstract

80. Vaizey CJ, Kamm MA. Injectable bulking agents for treating faecal incontinence. Br J Surg. 2005 May;92(5):521-7. Abstract

81. Maeda Y, Laurberg S, Norton C. Perianal injectable bulking agents as treatment for faecal incontinence in adults. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD007959.Full text  Abstract

82. National Institute for Health and Care Excellence. Self-expanding implant insertion into the intersphincteric space for faecal incontinence. Jan 2021 [internet publication].Full text

83. Norton C, Burch J, Kamm MA. Patients' views of a colostomy for fecal incontinence. Dis Colon Rectum. 2005 May;48(5):1062-9. Abstract

84. US Food and Drug Administration. FDA drug safety communication: FDA warns of possible harm from exceeding recommended dose of over-the-counter sodium phosphate products to treat constipation. Jan 2014 [internet publication].Full text

85. National Institute for Health and Care Excellence (UK). Peristeen transanal irrigation system for managing bowel dysfunction. Jun 2022 [internet publication].Full text

86. De Ganck J, Everaert K, Van Laecke E, et al. A high easy-to-treat complication rate is the price for a continent stoma. BJU Int. 2002 Aug;90(3):240-3. Abstract

87. Giordano P, Renzi A, Efron J, et al. Previous sphincter repair does not affect the outcome of repeat repair. Dis Colon Rectum. 2002 May;45(5):635-40. Abstract

88. Efron JE, Corman ML, Fleshman J, et al. Safety and effectiveness of temperature-controlled radio-frequency energy delivery to the anal canal (Secca procedure) for the treatment of fecal incontinence. Dis Colon Rectum. 2003 Dec;46(12):1606-16. Abstract

89. National Institute for Health and Care Excellence. Endoscopic radiofrequency therapy of the anal sphincter for faecal incontinence. May 2011 [internet publication].Full text

90. Takahashi-Monroy T, Morales M, Garcia-Osogobio S, et al. SECCA procedure for the treatment of fecal incontinence: results of five-year follow-up. Dis Colon Rectum. 2008 Mar;51(3):355-9. Abstract

91. Visscher AP, Lam TJ, Meurs-Szojda MM, et al. Temperature-controlled delivery of radiofrequency energy in fecal incontinence: a randomized sham-controlled clinical trial. Dis Colon Rectum. 2017 Aug;60(8):860-5. Abstract

92. George AT, Kalmar K, Sala S, et al. Randomized controlled trial of percutaneous versus transcutaneous posterior tibial nerve stimulation in faecal incontinence. Br J Surg. 2013 Feb;100(3):330-8. Abstract

93. Govaert B, Pares D, Delgado-Aros S, et al. A prospective multicentre study to investigate percutaneous tibial nerve stimulation for the treatment of faecal incontinence. Colorectal Dis. 2010 Dec;12(12):1236-41. Abstract

94. Boyle DJ, Prosser K, Allison ME, et al. Percutaneous tibial nerve stimulation for the treatment of urge fecal incontinence. Dis Colon Rectum. 2010 Apr;53(4):432-7. Abstract

95. National Institute for Health and Care Excellence. Percutaneous tibial nerve stimulation (PTNS) for faecal incontinence. May 2011 [internet publication].Full text

96. Horrocks EJ, Thin N, Thaha MA, et al. Systematic review of tibial nerve stimulation to treat faecal incontinence. Br J Surg. 2014 Apr;101(5):457-68. Abstract

97. Knowles CH, Horrocks EJ, Bremner SA, et al. Percutaneous tibial nerve stimulation versus sham electrical stimulation for the treatment of faecal incontinence in adults (CONFIDeNT): a double-blind, multicentre, pragmatic, parallel-group, randomised controlled trial. Lancet. 2015 Oct 24;386(10004):1640-8. Abstract

98. van der Wilt AA, Giuliani G, Kubis C, et al. Randomized clinical trial of percutaneous tibial nerve stimulation versus sham electrical stimulation in patients with faecal incontinence. Br J Surg. 2017 Aug;104(9):1167-76. Abstract

99. Horrocks EJ, Chadi SA, Stevens NJ, et al. Factors associated with efficacy of percutaneous tibial nerve stimulation for fecal incontinence, based on post-hoc analysis of data from a randomized trial. Clin Gastroenterol Hepatol. 2017 Dec;15(12):1915-21. Abstract

100. Sugrue J, Lehur PA, Madoff RD, et al. Long-term experience of magnetic anal sphincter augmentation in patients with fecal incontinence. Dis Colon Rectum. 2017 Jan;60(1):87-95. Abstract

101. National Institute for Health and Care Excellence. Insertion of a magnetic-bead band for faecal incontinence. Mar 2014 [internet publication].Full text

102. Frudinger A, Kölle D, Schwaiger W, et al. Muscle-derived cell injection to treat anal incontinence due to obstetric trauma: pilot study with 1 year follow-up. Gut. 2010 Jan;59(1):55-61. Abstract

103. Boyer O, Bridoux V, Giverne C, et al. Autologous myoblasts for the treatment of fecal incontinence: results of a phase 2 randomized placebo-controlled study (MIAS). Ann Surg. 2018 Mar;267(3):443-50. Abstract

104. Richter HE, Matthews CA, Muir T, et al. A vaginal bowel-control system for the treatment of fecal incontinence. Obstet Gynecol. 2015 Mar;125(3):540-7. Abstract

105. Omar MI, Alexander CE. Drug treatment for faecal incontinence in adults. Cochrane Database Syst Rev. 2013 Jun 11;(6):CD002116.Full text  Abstract

106. Rao SS. Current and emerging treatment options for fecal incontinence. J Clin Gastroenterol. 2014 Oct;48(9):752-64.Full text  Abstract

107. Bharucha AE, Rao SSC, Shin AS. Surgical interventions and the use of device-aided therapy for the treatment of fecal incontinence and defecatory disorders. Clin Gastroenterol Hepatol. 2017 Dec;15(12):1844-54.Full text  Abstract

108. Heymen S, Jones KR, Ringel Y, et al. Biofeedback treatment of fecal incontinence: a critical review. Dis Colon Rectum. 2001 May;44(5):728-36. Abstract

Use of this content is subject to our disclaimer