Incontinence, Fecal

Kalyanakrishnan Ramakrishnan, MD Reviewed 06/2019

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

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

Omar MI, A...

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...

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