Surgery » General Surgery » Anal & Perianal

Faecal Incontinence

Faecal incontinence associated with acute gastroenteritis does not indicate proctological investigations unless it becomes prolonged or recurrent.The aetiology includes acute infectious diarrhea, faecal impaction (overflow incontinence), over-consumption of laxatives, injuries of the anal sphincter, rectal prolapse, anorectal tumours, congenital malformations, neurological diseases, proctitis, colitis and neurogenic causes. Proctological examination is the basis of diagnosis: inspection, proctoscopy, and recto-sigmoidoscopy. Behavioural techniques, such as "biofeedback" (teaching patients to improve sphincter function using physiological feedback, such as anal electromyography or pressure measurement) and sphincter exercises help about two thirds of patients, including some with structural sphincter damage. Topical pharmacological therapies have radically altered the management of anal fissure, thereby preventing the need for surgical sphincterotomy. Only a very small proportion of patients require surgical treatment.

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