Your patient with fecal incontinence requires further investigation. A sigmoidoscopy -- to rule out any rectosigmoid pathology -- is important. Rectal prolapse should be investigated and if your patient is a woman, consider rectocele. In my experience, I tend to see these problems in older patients where the pelvic muscle tone has deteriorated. I find that bulking agents sometimes help, so give them a try. Taking loperamide before going out is a practical approach, but pathology should always be ruled out first. AS