CLINICAL PRACTICE GUIDELINESThe American Society of Colon and Rectal SurgeonsClinical Practice Guidelines for the Management ofFecal IncontinenceLiliana G.Bordeianou,M.D.,M.P.H..Amy J.Thorsen,M.D.2Deborah S.Keller,M.S.,M.D.3 Alexander T.Hawkins,M.D.,M.P.H.Craig Messick,M.D.5.Lucia Oliveira,M.D.,Ph.D.5.Daniel L.Feingold,M.D.Amy L.Lightner,M.D..Ian M.Paquette,M.D.1 Division of Colon and RectalSurgery,Massachusetts General Hospital and Harvard Medical School,Boston,Massachusetts2 Division of Colon and Rectal Surgery,University of Minnesota,Minneapolis,Minnesota3 Colorectal Center,Lankenau Hospital,Philadelphia,Pennsylvania4 Section of Colon and Rectal Surgery,Vanderbilt University Medical Center,Nashville,Tennessee5 The University of Texas MD Anderson Cancer Center,Houston,Texas6 Anorectal Physiology Department of Rio de Janeiro,CEPEMED,Rio de Janeiro,Brazil7 Division of Colon and Rectal Surgery,Rutgers University,New Brunswick,New Jersey8 Department of Colon and Rectal Surgery,Cleveland Clinic,Cleveland,Ohio9 Division of Colon and RectalSurgery,University of Cincinnati College of Medicine,Cincinnati,Ohiohe American Society of Colon and Rectal Surgeonsguidelines.These guidelines should not be deemed inclusive(ASCRS)is dedicated to ensuring high-qualityof all proper methods of care nor exclusive of methods ofpatient care by advancing the science and preventioncare reasonably directed toward obtaining the same results.and management of disorders and diseases of the colon,rec-The ultimate judgment regarding the propriety of any spe-tum,and anus.The Clinical Practice Guidelines Committeecific procedure must be made by the physician consideringis composed of society members who are chosen becauseall the circumstances presented by the individual patient.they have demonstrated expertise in the specialty of colonand rectal surgery.This committee was created to leadinternational efforts in defining quality care for condi-STATEMENT OF THE PROBLEMtions related to the colon,rectum,and anus and developFecal incontinence (FI)is generally defined as the uncon-clinical practice guidelines based on the best available evi-trolled passage of feces for a duration of at least 3 months indence.Although not proscriptive,these guidelines providean individual who previously had control.2 The prevalenceinformation on which decisions can be made and do notof FI varies widely depending on the specific definition useddictate a specific form of treatment.These guidelines areand the population surveyed,ranging between 1.4%and 18%intended for the use of all practitioners,health care workers,in women.3-8 A study of bowel function in a primary careand patients who desire information on the managementnetwork found the incidence of FI to be 12.5%,with manyof the conditions addressed by the topics covered in thesepatients reporting moderate to severe FI(Vaizey score morethan 8).The Mature Women's Health Study administeredEarn Continuing Education (CME)credit online at cme.lww.com.Thisa
