ABSTRACT
Fecal incontinence is a socially disabling disease. It is associated with reduced personal hygiene and frequently leads to social isolation and loss of self-esteem).1 Due to personal embarrassment, the true prevalence remains unclear. Symptoms may vary from occasional gas incontinence to minor soiling to gross fecal incontinence of solid stool. The two groups of individuals mostly affected are females and the elderly. It is estimated that 0.5-1.5%2 of the normal population suffer from fecal incontinence; if soiling is included, the incidence increases to 5%.3 In geriatric wards, the incidence is as high as 30%; in psychiatric wards, up to 50%.4 The pathophysiology of this disease is multifactorial and not yet fully understood. While decades ago fecal incontinence was often seen as ‘idiopathic’, since the advent of physiology testing, major progress has been made in understanding the complexity of this disease. The aim of this chapter is to highlight the various forms of fecal incontinence and to explain possible pathophysiologic mechanisms as a basis for a proper individually tailored treatment.
