Although fecal incontinence and disorders of defecation are not uncommon, these disorders are poorly understood by most physicians. Successful management requires an understanding of colorectal function, delineation of the problem and potential contributing factors, careful examination of the anorectal and pelvic floor areas, and psychosocial assessment. Specialized studies to evaluate colorectal function frequently help determine patterns of abnormality and may suggest appropriate therapeutic approaches. Therapeutic options include pharmacologic, behavioral, and surgical approaches, which often ameliorate symptoms and dramatically improve quality of life.