Editing Fecal incontinence (section)

=== Definition ===

There is no globally accepted definition,<ref name="ASCRS core subjects FI" /> but fecal incontinence is generally defined as the recurrent inability to voluntarily control the passage of bowel contents through the anal canal and expel it at a socially acceptable location and time, occurring in individuals over the age of four.<ref name="ASCRS core subjects FI">{{cite web| vauthors = Kaiser AM |title=ASCRS core subjects: fecal incontinence|url=http://www.fascrs.org/physicians/education/core_subjects/2009/fecal_incontinence/|publisher=ASCRS|access-date=29 October 2012|archive-url=https://web.archive.org/web/20130520084112/http://www.fascrs.org/physicians/education/core_subjects/2009/fecal_incontinence/|archive-date=20 May 2013|url-status=dead}}</ref><ref name="ASCRS textbook">{{cite book |url=https://archive.org/details/ascrstextbookofc0000unse |title=The ASCRS textbook of colon and rectal surgery |publisher=Springer |year=2007 |isbn=978-0-387-24846-2 |editor=Bruce G. Wolff |location=New York |pages=[https://archive.org/details/ascrstextbookcol00wolf/page/n673 653]–664 |display-editors=etal |url-access=limited}}</ref><ref name="Yamada textbook">{{cite book|editor=Tadataka Yamada |editor2=David H. Alpers |display-editors=etal |title=Textbook of gastroenterology|url=https://archive.org/details/textbookgastroen00yama_718 |url-access=limited |year=2009|publisher=Blackwell Pub.|location=Chichester, West Sussex|isbn=978-1-4051-6911-0|edition=5th|pages=[https://archive.org/details/textbookgastroen00yama_718/page/n1739 1717]–1744}}</ref><ref name="NICE guidelines" /><ref name="Coloproctology textbook">{{cite book| veditors = Wexner AP, Zbar SD |title= Coloproctology |url=https://archive.org/details/coloproctology00zbar|url-access=limited|year=2010|publisher=Springer|location=New York|isbn=978-1-84882-755-4|pages=[https://archive.org/details/coloproctology00zbar/page/n116 109]–119}}</ref> "Social continence" has been given various precise definitions for the purposes of research; however, generally it refers to symptoms being controlled to an extent that is acceptable to the individual in question, with no significant effect on their life. There is no consensus about the best way to classify FI,<ref name="NICE guidelines" /> and several methods are used.

Symptoms can be directly or indirectly related to the loss of bowel control. The direct (primary) symptom is a lack of control over bowel contents which tends to worsen without treatment. Indirect (secondary) symptoms, which are the result of leakage, include [[pruritus ani]] (an intense itching sensation from the anus), perianal [[dermatitis]] (irritation and inflammation of the skin around the anus), and urinary tract infections.<ref name="ASCRS core subjects FI" /> Due to embarrassment, people may only mention secondary symptoms rather than acknowledge incontinence. Any major underlying cause will produce additional signs and symptoms, such as protrusion of mucosa in external [[rectal prolapse]]. Symptoms of fecal leakage (FL) are similar and may occur after defecation. There may be loss of small amounts of brown fluid and staining of the underwear.<ref name="ASCRS textbook" />