Skip to main content

Incontinence, Fecal

Kalyanakrishnan Ramakrishnan, MD Reviewed 06/2018
 


BASICS

Defined as continuous or recurrent involuntary passage of fecal material through the anal canal for >1 month in an individual at least 4 years of age 
  • Involves recurrent, involuntary loss of ...

DIAGNOSIS

Diagnosis is based on history and physical findings. 

HISTORY

  • Patients seldom volunteer information about fecal incontinence. Direct questioning is important.

  • Problem-specific history includes ...

TREATMENT

GENERAL MEASURES

  • In ambulatory patients, scheduled (or prompted) defecation is effective, particularly in those with overflow incontinence.

  • Kegel exercises to strengthen pelvic floor

  • If bed-bou...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Periodic rectal exam 

Patient Monitoring

Consider impaction if there is <1 bowel movement every other day in patients with fecal incontinence. 

DIET

  • High fiber (20...

REFERENCES

1
Tjandra JJ, Dykes SL, Kumar RR, et al. Practice parameters for the treatment of fecal incontinence. Dis Colon Rectum.  2007;50(10):1497–1507.
2
Omar MI, Alexander CE. Drug treatment for...

ADDITIONAL READING

Rao SSC. Fecal incontinence. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed....

CODES

ICD10

  • R15.9 Full incontinence of feces

  • R15.2 Fecal urgency

  • R15.0 Incomplete defecation

  • F98.1 Encopresis not due to a substance or known physiol condition

ICD9

  • 787.60 Full incontinence of feces

  • 787.63 F...

CLINICAL PEARLS

  • Scheduled defecation after meals, bulking agents, and scheduled enemas minimize impaction and are helpful in mild/moderate fecal incontinence.

  • Differentiate true incontinence from pseud...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×