Anatomical and Physiological Bases of Fecal Continence

Abstract

Fecal incontinence, i. e. the impaired ability to control gas or stool, is a disabling and distressing condition, which, when severe, causes progressive social isolation of the patient. However, it is a common condition, especially in older individuals, where prevalence has been reported to approach 60 per cent, and in women, where incontinence as a result of childbirth reaches 54 per cent [1]. Sultan and associates [2] found that 13 per cent of primigravidae and 23 per cent of multigravidae had some degree of incontinence in the first six weeks after delivery, and Mac Arthur and colleagues [3] reported that up to two years later 4 per cent still had the symptom. Of patients surgically treated, the female-to-male ratio is 4 to 1. In a recent epidemiological study published by the University of Illinois on JAMA in 1995, fecal incontinence was determined in 2.2 per cent of the general population [4]. Data from Great Britain suggest a community prevalence of 4.2 men and 1.7 women per 1000 people who are 15 to 64 years of age, and 10.9 men and 13.3 women per 1000 people who are 65 or older [5].