ABSTRACT
CHALLENGING CASE A 65-year-old woman and her 30-year-old daughter both present to your office with complaints of fecal incontinence. Both are G3 P3, all vaginal deliveries, and have had at least one delivery of a child of 8 pounds or more. Both have required an assistance device for delivery of one child. Both report fecal soiling for the last year. The older woman reports progressive uncontrolled passage of flatus and occasional identification of stool in her undergarments that she was unaware of having passed. The daughter reports incontinence to moderate amounts of stool despite attempts to delay defecation. There is additional incontinence associated with athletic activity.
