Fecal incontinence: Office-based management

The key to successful office-based management of fecal incontinence is appropriate characterization of the incontinence and a subsequent tiered approach to treatment. If possible, it is imperative to classify the underlying pathophysiology of the patient’s fecal incontinence as this will direct treatment strategies and may predict outcomes. The differential diagnosis of fecal incontinence is vast (Table 1) (1-3). Moreover, as the development of fecal incontinence is multifactorial, it is important that the clinician carefully extract and isolate which pathophysiologic factors are responsible for the incontinence. Improvement in any single factor may provide significant clinical improvements.