Fecal incontinence in adults: Etiology and evaluation
- Kristen M Robson, MD, MBA, FACG
Kristen M Robson, MD, MBA, FACG
- Assistant Professor
- Tufts University School of Medicine
- Anthony J Lembo, MD
Anthony J Lembo, MD
- Associate Professor of Medicine
- Harvard Medical School
Fecal incontinence has a significant social and economic impact and significantly impairs quality of life [1-5]. Fecal incontinence can contribute to the loss of the ability to live independently. [5,6]. This topic will review the etiology and evaluation of fecal incontinence in adults. Our recommendations are largely consistent with guidelines issued by the American College of Gastroenterology . The management of fecal incontinence in adults is discussed in detail, separately. (See "Fecal incontinence in adults: Management".)
TERMINOLOGY AND CLASSIFICATION
●Fecal incontinence is defined as the involuntary loss of solid or liquid feces.
●Anal incontinence is defined as the involuntary loss of solid or liquid feces or flatus.
Based on the mechanism of incontinence, fecal incontinence is divided into the following:
●Urge incontinence is characterized by the desire to defecate, but incontinence occurs despite efforts to retain stool.
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- TERMINOLOGY AND CLASSIFICATION
- PHYSIOLOGY OF DEFECATION
- ETIOLOGY AND PATHOGENESIS
- Anal sphincter weakness
- Decreased perception of rectal sensation
- Decreased rectal compliance
- Physical examination
- Laboratory studies
- Additional studies
- - Anorectal manometry
- - Endorectal ultrasound/magnetic resonance imaging
- - Defecography
- - Other
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS