[Fecal incontinence: various causes and treatments]

Three patients, two women aged 73 and 54 years and one man aged 46 years, had faecal incontinence for several years. All three patients had sphincter defects; two were managed conservatively and one was treated surgically with acceptable results. Of the many possible causes of faecal incontinence, a disturbed defecation pattern and obstetric trauma are most frequently encountered. After medical history and physical examination, anal endosonography is important in demonstrating or excluding an anal sphincter defect. Conservative treatment by means of a fibre-enriched diet, laxatives, pelvic floor exercises or daily enemas may provide a socially acceptable balance for the patient. When conservative management fails and a sphincter defect is present, sphincteroplasty is indicated.