Obstetrics, Gynecology, and Women's Health Institute, Center for Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH, 44195, USA,
Curr Urol Rep. 2014 Mar;15(3):388. doi: 10.1007/s11934-013-0388-8.
Fecal incontinence is the involuntary loss of solid or liquid stool. While the true prevalence of fecal incontinence is difficult to discern, it is estimated that almost 9 % of non-institutionalized women in the US experience this condition. Disorders leading to fecal urgency alone are usually related to rectal storage abnormalities while incontinence is often a result of anatomic or neurologic disruption of the anal sphincter complex. Many risk factors exist for fecal incontinence and include female sex, increasing age, higher body mass index (BMI), limited physical activity, smoking, presence of neuropsychiatric conditions, higher vaginal parity and history of obstetrical trauma, presence of chronic diarrhea and irritable bowel syndrome, or history of rectal surgery, prostatectomy and radiation. Evaluation of fecal incontinence involves a careful patient history and focused physical exam. Diagnostic tests include endorectal ultrasonography, anal manometry, anal sphincter electromyography, and defecography. Treatment strategies include behavioral, medical and surgical therapies as well as neuromodulation. Treatment is based on the presumed etiology of the condition and a multi-modal approach is often necessary to achieve the maximum benefit for patients.
粪便失禁是指固体或液体粪便的无意识流失。尽管粪便失禁的真实患病率难以确定，但据估计，美国近 9%的非住院女性患有这种疾病。仅导致粪便急迫的疾病通常与直肠储存异常有关，而失禁通常是肛门括约肌复合体解剖或神经功能障碍的结果。粪便失禁存在许多危险因素，包括女性、年龄增长、更高的身体质量指数 (BMI)、体力活动受限、吸烟、存在神经精神疾病、更高的阴道分娩次数和产科创伤史、慢性腹泻和肠易激综合征、或直肠手术、前列腺切除术和放疗史。粪便失禁的评估包括仔细的病史和重点体格检查。诊断测试包括直肠内超声、肛门测压、肛门括约肌肌电图和排粪造影。治疗策略包括行为、药物和手术治疗以及神经调节。治疗基于疾病的假定病因，通常需要多模式方法才能为患者带来最大益处。
