Incontinence, Fecal

Kalyanakrishnan Ramakrishnan, FRCS (EDINBURGH), M.D. Reviewed 04/2024

BASICS

Continuous or recurrent involuntary passage of feces through the anal canal for >1 month in an individual who has previously achieved continence.

Diagnosis is based on history and physical findings.

Patients seldom volunteer information about fecal incontinence. Direct questioning is important.
Problem-specific history includes ...

In ambulatory patients, scheduled (or prompted) defecation is effective, particularly in those with overflow incontinence.
Kegel exercises to strengthen pelvic floor
If bed-bou...

Periodic rectal exam

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

High fiber (20...

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

Omar MI, Alexander CE. Drug treatment for faeca...

Da Silva G, Sirany A. Recent advances in managing fecal incontinence. F1000Res. 2019;8:F1000 Faculty Rev-1291. doi: 10.12688/f1000research.15270.2.

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

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