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Chapter 29 - Fecal Incontinence

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press:  30 June 2022

By
Alayne D. Markland ,
Jan Busby-Whitehead  and
William E. Whitehead
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

Fecal incontinence (FI) is defined as the involuntary loss of solid or liquid stool and has an enormous impact on quality of life. Continence depends on a number of factors including cognitive function, stool volume and stool consistency, colonic transit, rectal compliance, anal sphincter function, anorectal sensation, and anorectal reflexes. Loss of continence often results from impairment in any of these factors. Initial evaluation consists of a focused history and a physical examination looking for potential reversible and/or treatable factors. First-line treatment include dietary, behavioral, and pharmacologic management approaches in community-dwelling and long-term care settings. If first-line treatments are not effective, additional evaluation with anorectal manometry and other tests may be warranted. Surgical treatments for FI may improve symptoms and more efficacy data is needed, especially among older adults. Therapeutic options using behavioral, pharmacological, and surgical approaches can lead to symptomatic improvements or cure for FI and increased quality of life for the older patient.

Keywords

fecal incontinencestool consistencypelvic floor muscle exercisesbehavioral therapyaccidental bowel leakageneuromodulationsurgery
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 364 - 372
Publisher: Cambridge University Press
Print publication year: 2022

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