Fecal incontinence is the involuntary passage of feces, which may occur gradually (as in dementia) or suddenly (as in spinal cord injury). It usually results from fecal stasis and impaction secondary to reduced activity, inappropriate diet, or untreated painful anal conditions. It can also result from chronic laxative use; reduced fluid intake; neurologic deficit; pelvic, prostatic, or rectal surgery; and the use of certain medications, including antihistamines, psychotropics, and iron preparations.

In elderly patients, fecal incontinence commonly follows any loss or impairment of anal sphincter control. The incontinence may be transient or permanent and affects up to 10% of patients in assisted living or extended care facilities. Not usually a sign of serious illness, fecal incontinence can seriously impair an elderly patient’s physical and psychological well-being.

Patients with fecal incontinence should be carefully assessed for underlying disorders. Most can be treated; some can even be cured. Treatment aims to control the condition through bowel retraining or other behavioral management techniques, diet modification, drug therapy, pessaries, and, possibly, surgery.