Faecal Incontinence

Faecal incontinence is defined as either involuntary passage or inability to control the discharge of faecal matter through the anus. Three subtypes of faecal incontinence have been identified [5]:

1. Passive incontinence: involuntary discharge of stool or gas without the patient's awareness.

2. Urge incontinence: discharge of faecal matter despite the patient's active attempts to retain bowel contents.

3. Faecal seepage: leakage of stool that follows otherwise normal evacuation.

The severity of incontinence can range from unintentional elimination of flatus to seepage of liquid faecal matter or, sometimes, to the complete evacuation of bowel contents. These events can be a cause of considerable embarrassment for patients, affecting in the long run their self-esteem and causing in turn social isolation and a poorer quality of life [6]. To maintain normal faecal continence, it is important to preserve the neuromuscular integrity of the rectum, anus and adjoining pelvic floor musculature. It follows that incontinence occurs when there is disruption of one or more mechanisms that maintain continence; the disruption is to such an extent that other mechanisms are unable to compensate. Incontinence in patients affected by IBD and by FAP is caused by [5]:

- Decrease in rectal compliance and accommodation.

- Disruption of the external anal sphincter complex due to (a) anorectal surgery for fistulas, hemorrhoids or fissure; (b) anal dilation of lateral sphincterotomy.

The aim of the treatment is to restore continence and improve quality of life.

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