[Transformation and evidence-based progress of fecal incontinence treatment models]

Fecal incontinence is a refractory disease.The main clinical manifestation is that patients cannot control the discharge of gas, solid or liquid feces in the rectum autonomously. It significantly compromises patients'quality of life and imposes substantial economic burdens on both families and the healthcare system. With the evolution of therapeutic paradigms and innovations in diagnosis and treatment modalities, the management approach for fecal incontinence has progressively evolved:early strategies centered on anatomical reconstruction, following the advent of sacral nerve modulation, the focus transitioned to the restoration of physiological function;and since the turn of the 21st century ,emphasis has been placed on comprehensive evaluation and stratified therapy, leading to the establishment of a precision-oriented and patient-tailored diagnostic and therapeutic framework.This paper examines the accumulation of evidence-based medical data and the drivers behind these shifts in treatment models to elucidate the underlying patterns in the management of FI. It also addresses current controversies, such as screening for asymptomatic anal sphincter defects and gaps in psychological support, proposing targeted solutions and stratified care pathways to inform clinical practice and future research.