ABSTRACT
This chapter discusses disturbances of the central nervous control and the reservoir function of the rectum as causes of fecal incontinence. The high-pressure zone should be included in the evaluation of the anal sphincter function. Pressure levels and the high-pressure zone can be expressed and calculated as the high-pressure area. One aspect of bowel control is the facility of cerebral inhibition of reflexes, which include defecation. Cerebral causes are probably dominating for fecal incontinence in elderly people with cerebrovascular disease and dementia. The urgency and fecal incontinence in connection with inflammation of the rectum should be treated with the intention to diminish or eliminate the inflammatory reaction. A normal anal sphincter apparatus is no guarantee against leakage of bowel contents. One should be aware of the fact that it is an oversimplification to pay attention merely to the anal sphincter muscles when taking care of patients with suspected or manifest fecal incontinence.
