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Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents — including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom, not a diagnosis.
Fecal incontinence or constipation occurs when there is a problem with normal bowel functioning. This could be for a variety of reasons. The normal defecation pathway involves contractions of the colon which helps mix the contents, absorb water and propel the contents along. This results in feces moving along the colon to the rectum. [4]
In fecal incontinence (FI), surgery may be carried out if conservative measures alone are not sufficient to control symptoms. There are many surgical options described for FI, and they can be considered in 4 general groups. [1] Restoration and improvement of residual sphincter function ; sphincteroplasty (sphincter repair)
Children who have fecal incontinence after the repair of an imperforate anus are usually those born with a bad prognosis type of defect and severe associated defects (defect of the sacrum, poor muscle complex). However, such children can still achieve a good quality of life when treated with the bowel management program.
A 2007 review by the Cochrane Collaboration was cautiously optimistic about the results of sacral nerve stimulation in fecal incontinence, although it also concluded that trial periods of stimulation did not adequately identify patients that would benefit from the procedure, and that more longer-term studies were needed. [2] [needs update]
Compared to other surgical treatment options for fecal incontinence, implantable bulking agents appear to be safe. [6] Therefore, it is also suitable for elderly or frail patients. [6] However, complications are sometimes reported. For example, acute sepsis (infection) at the implantation site has been rarely recorded. [6]
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