[Fecal incontinence - symptoms are guiding therapy]

Area of Science:

• Gastroenterology
• Geriatrics
• Urology

Background:

• Fecal incontinence (FI) is a significant and increasing medical concern, particularly affecting the geriatric population due to rising life expectancy.
• Prevalence estimates range from 4% in adults to over 50% in octogenarians, with underreporting likely leading to underestimation.

Purpose of the Study:

• To review the current understanding of fecal incontinence, including its prevalence, diagnosis, and management strategies.
• To highlight the multifactorial nature of FI and the importance of patient compliance in therapeutic approaches.

Main Methods:

• Diagnosis relies primarily on patient history and caregiver information, with technical procedures being secondary.
• Review of established and emerging therapeutic interventions for fecal incontinence.

Main Results:

• FI is often multifactorial, involving progressive loss of anorectal continence.
• Conservative treatments include lifestyle modifications, physiotherapy, and medical therapy, with varying patient compliance.
• Sacral neuromodulation has emerged as a successful invasive treatment, and in some cases, a permanent stoma can improve quality of life.

Conclusions:

• Effective management of fecal incontinence requires a comprehensive approach tailored to the individual patient.
• While conservative measures are the mainstay, advanced interventions like sacral neuromodulation and surgical options like stoma creation offer solutions for refractory cases.