Between 5-10% of elderly men and women experience fecal leakage, which can vary in severity and may include the loss of gas or soiling. Fecal leakage can occur without sensation, during exertion, or due to urgency. It can be caused by nerve damage (such as pudendal nerve damage), compromised integrity of the anal sphincter, or chronic constipation.
Factors contributing to difficulties in bowel movements include a low-fiber diet, inadequate fluid intake, intestinal motility disorders, and rectal and intestinal prolapse (such as rectocele and enterocele). Severe and prolonged constipation can also lead to fecal and urinary leakage.
Treatment for fecal leakage often involves dietary changes, establishing regular and appropriate bowel habits, and maintaining cleanliness in the anal and urethral areas. Where possible, a combination of physical therapy with rectal biofeedback and drug therapy to prevent constipation and improve rectal tone can be effective. If there is a confirmed tear in the anal sphincter and no irreversible nerve damage, repairing the anal sphincter muscle can be a treatment option, even for older women. However, implantation of an artificial sphincter is not generally considered an appropriate treatment option for the elderly population.