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Fecal Incontinence

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Geriatric Gastroenterology

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Abstract

Fecal incontinence (FI) is the involuntary loss of either flatus or stool and a socially awkward and underreported diagnosis. A detailed history and physical examination are indicated for evaluation of incontinence. Diagnostic testing modalities include anorectal manometry, electromyography, pudendal nerve terminal motor latency, endoanal ultrasound, and defecography, along with scoring systems to rate the severity of incontinence and resulting quality of life indicators. Patients with FI should be educated on maintaining anal hygiene. Conservative measures include dietary modification, pharmacologic agents, and bowel management regimens. Mild FI is managed through pelvic floor exercises or biofeedback therapy. Those with intact sphincters and weak pudendal nerves are suitable for sacral nerve stimulation. Defective sphincters are managed through sphincteroplasty or an artificial bowel sphincter. Very rarely, some patients require a colostomy to improve quality of life. Treatment is best individualized.

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Authors and Affiliations

  1. Colon and Rectal Surgery, Colon and Rectal Surgeons of Central New Jersey, East Brunswick, NJ, USA

    Sanjiv K. Patankar

  2. Department of Surgery, John Muir Medical Center, Walnut Creek, CA, USA

    Negar M. Salehomoum

Authors
  1. Sanjiv K. Patankar
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  2. Negar M. Salehomoum
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Correspondence to Sanjiv K. Patankar .

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Editors and Affiliations

  1. Department of Medicine, Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Department of Medicine, Division of Geriatrics, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA

    T.S. Dharmarajan

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Patankar, S.K., Salehomoum, N.M. (2021). Fecal Incontinence. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_73

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  • DOI: https://doi.org/10.1007/978-3-030-30192-7_73

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  • Print ISBN: 978-3-030-30191-0

  • Online ISBN: 978-3-030-30192-7

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