[Fecal incontinence: methods of exploration].

Faecal incontinence is defined as the involuntary and sometimes unconscious release of liquid and/or solid faecal matter by the anus. The clinical history and examination and complementary investigations are able to direct the aetiological diagnosis: in particular, one should look for chronic constipation ("spurious diarrhoea"). After elimination of an organic cause (tumour, proctitis...), the most appropriate therapeutic procedure will be based on the results of further investigations, such as: defaecography, electromyography of the anal sphincter, ano-rectal manometry, measurement of the rectal capacity, measurement of the coefficient of elasticity of the rectal wall and tests of the rectal continence of fluids. Following this survey, the cause of the faecal incontinence can be determined: anal sphincter deficiency, anomaly of discriminative sensation (mucosal or neurological lesion), reduction of the rectal distensibility or abnormal rectal contractile activity. Some patients, selected on the basis of precise manometric criteria, may be suitable for reeducation by means of "bio-feedback". Faecal incontinence is a condition which is sometimes associated with social disinsertion. Hopefully, as a result of the new methods of investigation of ano-rectal function, it will now be possible to determine the aetiological mechanisms responsible for the incontinence, resulting in more effective treatment.