Fecal incontinence in the elderly

A bibliographic review on the diagnosis, evaluation and treatment of fecal incontinence (FI) was realized in different databases of the Sistema de Bibliotecas, Documentacion e Informacion (SIBDI) and the Biblioteca Nacional de Salud y Seguridad Social (BINASS) to understand the condition and to provide a better approach, as well as to optimize the quality of life of the Costa Rican elderly population. The etiological factors of FI were identified in the elderly. Validated questionnaires were described to help identify the severity and impact of FI on the quality of the elderly. The types of treatment for the elderly with IF were described. Diagnostic studies such as anal endosonography, anal manometry, pudendal latency time test, defecography, and colonoscopy were described. The endoanal ultrasound -considered the gold standard- and anal manometry allow to obtain a more complete evaluation of the sphincteric apparatus. Hygienic-dietary and behavioral recommendations were considered the first-choice therapies for the management of FI. Biofeedback therapy is used in patients where conservative management has failed, as long as the patient has a cognitive, visual and sensorial capacity adequate for successful therapy. Surgical treatments are recommended only in cases of presenting a significant structural injury or severe alteration of the sphincter apparatus and this is the only alternative. Finally, it is important to identify and treat the causes of FI in time to create a positive impact by to improving the quality of life of the elderly