Fecal incontinence

Fecal incontinence is a comparatively frequent clinical picture. A functioning continence consists of a complex interplay of the central, peripheral and autonomous nervous systems, a functioning gastrointestinal (GI) tract and anal sphincter complex. A distinction must be made between congenital and acquired fecal incontinence. In addition to the medical history the clinical examination is essential because the first consultation can often conclude on the nature of the problem. The ultimate goal of therapy should always be subjective improvement of symptoms thus increasing the individual quality of life. For the first occurrence of fecal incontinence without severe comorbidities a conservative therapy attempt is advisable. If the conservative therapy is not successful or pelvic floor incidents are present, surgical therapy is advisable. In summary there is no standard treatment but the optimal treatment seems to be a complex combination of surgical and non-surgical therapies.