The Patient with Fecal Incontinence

Abstract

Normally, the rectum is empty, containing only mucus and small amounts of fecal fluid. The anus is held closed at rest by the internal sphincter. Formed stool is usually stored in the sigmoid colon. A stimulus, such as food entering the stomach (gastrocolic reflex), initiates peristalsis in the colon, pushing stool into the rectum. The internal sphincter relaxes (anorectal inhibitory reflex) allowing the stool to be sampled at the level of the pelvic floor. If appropriate, the stool will pass; if not, the external sphincter will squeeze tight, maintaining continence.