ABSTRACT
Fecal incontinence is a symptom of incompetence of the anorectum as continence organ to retain and store the rectosigmoidal contents sufficiently. For clinical and therapeutical use, some groups of fecal incontinence should be differentiated according to the etiology of incontinence. Idiopathic fecal incontinence without other symptoms or history of anal damage is the most common form of fecal incontinence. Pharmacological therapy of fecal incontinence can be tried with loperamide, an opioid which is primarily used in diarrhea, as it suppresses propulsive activity of the small intestine and colon. Biofeedback training of the pelvic floor and especially the external anal sphincter may be a very effective method in patients with neurogenic fecal incontinence or fecal incontinence caused by sensory or coordinative deficits. Controlled studies of the conservative treatment strategies in fecal incontinence are required, particularly as it has been demonstrated that unspecific effects are of considerable importance for the favorable results of biofeedback training in fecal incontinence.
