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World J Gastroenterol. Dec 28, 2013; 19(48): 9216-9230
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9216
Current management of fecal incontinence: Choosing amongst treatment options to optimize outcomes
Julie Ann M Van Koughnett, Steven D Wexner
Julie Ann M Van Koughnett, Steven D Wexner, Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, United States
Author contributions: Both authors contributed to research, writing and revisions of manuscript.
Supported by Dr. Wexner is a consultant and receives consulting fees in the field of fecal incontinence from: Incontinence Devices, Inc; Mediri Therapeutics, Inc.; Medtronic Inc.; Renew Medical; Salix Pharmaceuticals
Correspondence to: Steven D Wexner, MD, PhD(Hon), FACS, FRCS, FRCS(Ed), Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, United States. wexners@ccf.org
Telephone: +1-954-6596020 Fax: +1-954-6596021
Received: July 30, 2013
Revised: October 7, 2013
Accepted: November 2, 2013
Published online: December 28, 2013
Core Tip

Core tip: An increasing number of treatment options for the management of fecal incontinence have been developed. In addition to traditional options such as sphincteroplasty and colostomy, non-surgical options such as biofeedback and dietary modification may be considered for mild incontinence. Injectable materials and radiofrequency energy delivery are two newer treatments for mild incontinence. Surgical options for moderate to severe incontinence include sacral nerve stimulation, artificial bowel sphincter implantation, muscle transposition, antegrade continence enemas, sphincteroplasty, and colostomy formation. Treatment for fecal incontinence (repair, stimulation, replacement, augmentation, or diversion) must be individualized to the patient, considering the underlying cause and impact on quality of life of the fecal incontinence.