A practical guide to the diagnosis and management of fecal incontinence

Many physicians are unaware that fecal incontinence is often correctable. With appropriate and relevant diagnostic tests, medical treatment and/or surgical correction often leads to good functional results. General guidelines for diagnosis, evaluation, and management of fecal incontinence are provided. There are many causes of fecal incontinence, with obstetrical trauma being one of the most frequent. A detailed history, documentation of sphincter injury, and thorough physical examination will identify the cause of the problem in most patients. Management involves the use of antidiarrheal medication and fiber products, biofeedback, or enemas. A qualified surgeon should be consulted during the course of the patient's evaluation, particularly when medical therapy is unsuccessful. Knowledge of the appropriate diagnosis, evaluation, and management of fecal incontinence may result in more patients seeking medical attention and thus improving their quality of life.