Causes of fecal incontinence

  • All psychoneurological disorders can cause constipation and thus fecal overflow incontinence for rectal impaction.
  • Neurological disorders affecting at or below the sacral parasympathetic outflow, extrinsic and intrinsic innervation of the recto-ano-pelvic area.

Diagnosis of fecal incontinence

In all patients

    • Exclude structural recto-ano-pelvic alterations and fecal impaction.
    • Evaluate the presence of liquid stools.
    • Anorectal Manometry
    • Neurophysiologic investigations of the pelvic floor

In specific patients

  • Autonomic tests
  • Psychiatric assessment

Management of fecal incontinence

Fecal impaction (see constipation)

Liquid stools (see diarrhea)

Recto-Ano-Pelvic dysfunction with only partial or no denervation

      • *Toilet training
      • *Manometry-controlled biofeedback
      • *Physiotherapy
      • *Electrostimulation
      • *Loperamide

Recto-Ano-Pelvic dysfunction with total denervation

    • *Trigger defecatory reflex with physical maneuvers + glycerin, stimulant laxative suppository *Electrostimulation of S2-S3 roots.
    • *Malone anterograde enema
    • *Colostomy