Abstract

Faecal incontinence affects men and women of all ages. Daily or weekly episodes occur in about 2% of the adult population and in about 7% of healthy independent adults over the age of 65.1 2 3 4 The disorder causes great personal disability and has a high financial cost. In the United States, more than $400m each year is spent on faecal incontinence appliances alone, and faecal incontinence is the second commonest reason (more common than dementia) for requesting placement in a nursing home.5 A third of elderly people in retirement homes or hospital are incontinent for stool.

Issues related to faecal incontinence are especially relevant with a growing population of elderly people. Advances in understanding and treatment have led to improved treatments and a good outcome for most patients. Much progress has been brought about by the recent development of accurate and simple techniques for imaging the anal sphincter muscles.

This review focuses on advances in the understanding and treatment of faecal incontinence. It is not a systematic review but is based on a choice of areas that I feel are of greatest recent importance, supplemented by a Medline search using the keywords “faecal incontinence.”