Fecal incontinence: part 4 of a series of articles on incontinence

Abstract

Background: The aging of the population will make fecal incontinence an increasingly important socioeconomic problem in the coming decades. Already today, the cost to society of treating incontinence with inserts, diapers, and closed systems exceeds the total cost of all cardiac and anti-inflammatory medications.

Methods: This article is based on a selective review of the literature and on clinical experience. No meta-analyses on this topic have yet been published.

Results: Surveys in highly industrialized countries in the Western Hemisphere have shown that about 5% of the population suffers from fecal incontinence of varying degrees of severity. This condition will become more common, in both relative and absolute terms, in the coming decades. Various methods of care and therapy are currently available for fecal incontinence, yet many patients do not seek medical help for it because of embarrassment. Thus, its true prevalence is certainly higher than the surveys imply.

Conclusion: The challenge today, therefore, is not just to encourage patients to seek medical help early, but also to raise physicians' awareness of fecal incontinence and their readiness to treat it, so that they can provide competent individual counseling and treatment to all patients who suffer from it.

Figure 1

Anatomy: cross-section of the continence organ; with the kind permission of Dr. Kade Pharmazeutische Fabrik GmbH, Berlin

Figure 2

Rectal prolapse; triggered on the lavatory

Figure 3

MRI scan of the sphincter area with contrast substance