New horizons in the treatment of fecal incontinence

Fecal incontinence affects the quality of life, and causes significant embarrassment. Incontinence mostly affects elderly females. The majority of affected individuals do not seek medical attention because of embarrassment and unawareness of treatment options. Assessment of the severity of incontinence and its effect on the quality of life and evaluation of the anatomy and function of the pelvic floor, rectum and anus, are essential for the proper selection of treatment options. In mild to moderate incontinence, non-invasive treatment with diet and biofeedback may be worthwhile. Invasive treatments include minor procedures, such as "bulking" of the internal sphincter, using injectable agents or radiofrequency energy, and major surgical procedures such as neosphincter operations using the gracilis muscle or artificial bowel sphincter. This review focuses on the new treatment modalities of fecal incontinence.