Fecal Incontinence in Women: Causes and Treatment

Ashima Makol; Madhusudan Grover; William E Whitehead


Women's Health. 2008;4(5):517-528. 

In This Article

Case Definition

Fecal incontinence refers to the involuntary loss of fecal matter from the anal canal.[7] There is no consensus on whether the definition should include involuntary loss of flatus versus being restricted to involuntary loss of solid or liquid stool or mucus. Patients often report that the involuntary loss of flatus should be included in the definition because it is very embarrassing and has an adverse impact on QOL,[8] and some epidemiological studies[9] and assessment scales[10] include flatus in their definition. However, the involuntary loss of flatus occurs very commonly in healthy individuals, making it difficult to discriminate health from disease; for this reason, many physicians prefer to exclude flatus from the definition. There is an evolving consensus to use the term FI to refer only to involuntary loss of solid or liquid stool or mucus and to use the term anal incontinence to include flatus as well as solid or liquid stool and mucus.[11] Clinicians often distinguish among three subtypes of FI that appear to have different etiologies and different treatments:

  • Passive incontinence – refers to the involuntary discharge of stool or gas without awareness;

  • Urge incontinence – refers to the discharge of fecal matter in spite of active attempts to retain bowel contents;

  • Fecal soiling – is the staining of underwear without loss of significant amounts of fecal material.[12]

The severity of FI is related to:

  • The frequency of incontinence

  • The type of fecal material lost

  • The volume of stool lost[10,13]

The impact of FI on QOL is directly related to these three factors.


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