Fecal incontinence: hope for an underdiagnosed condition

Fecal incontinence is often suffered in silence leading one to become a social recluse. This has led to the belief that the problem does not exist and therefore underdiagnosed. In the last decade, much has been learnt about the understanding of continence and defecation. Quantification of appropriate physiological parameters associated with fecal incontinence have allowed the patients to be assessed using a logical algorithm. More importantly, parallel developments in management techniques of fecal incontinence now allow the categorised patients to be managed logically. The assessment is thus translated into appropriate management plans which range from simple nonoperative medical and dietary manipulation to pelvic floor retraining, sphincter augmentation and finally sphincter reconstruction.