A CLINICAL APPROACH TO FECAL INCONTINENCE

Fecal incontinence is the impaired ability to control gas or stool. It is a disabling and distressing condition. Its exact incidence and pre valence are unknown. It is a disorder about which patients are frequen tly reluctant to discuss, even with their physician. However, it is a common condition especially in older individuals, where the prevalence has been reported to approach 60%. In women, incontinence reaches 54% as a result of childbirth. Of the patients surgically treated, the fe male-to-male ratio is 4 to 1. In an epidemiological study to identify its community-based prevalence, the University of Illinois determined fecal incontinence existed in 2.2% of the general population. There is available treatment for fecal incontinence. Many patients improve wit h conservative treatment (constipating agents, antidiarrheal medicatio ns, dietary changes) or with biofeedback. For patients where conservat ive treatment has failed, surgical treatment (direct-apposition sphinc ter repair, overlapping sphincteroplasty, postanal repair, neosphincte r procedures) may be successful.