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The anorectum is the caudal end of the gastrointestinal tract, and is responsible for fecal continence and defecation. In humans, defecation is a viscerosomatic reflex that is often preceded by several attempts to preserve continence. Continence has been defined as the ability to retain a bodily discharge voluntarily.
They become housebound and prefer to pass the day very close to the toilet to avoid losing feces. The exact incidence of FI is uncertain because of patients' hesitation to seek help from their physicians. Women seem to be at higher risk, mostly due to obstetric damage to the anal sphincters; however, during the last decade, an increasing interest has been dedicated to those forms of FI related to nontraumatic factors, which reach a relevant incidence (Bharucha, 2003). Older subjects are at very high risk, especially those with disabilities and those who are institutionalized. Moreover, young people are often affected. These factors create a significant economic impact for society, not only due to direct and indirect costs, but also due to intangible costs. FI may result from a variety of pathophysiological situations, and various risk factors can cause a wide range of inability to control feces passage. Therefore, an accurate diagnostic workup of each patient is fundamental. Although not fully agreed upon by all physicians, a multimodal diagnosis, using a multiparametric evaluation, seems to allow the most thorough understanding of FI pathophysiology and to indicate optimal treatment. These are really the most important and challenging aspects of FI management. ...
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