Intended for healthcare professionals


Managing faecal incontinence

BMJ 2005; 330 doi: (Published 27 January 2005) Cite this as: BMJ 2005;330:207
  1. Robert J C Steele, professor of surgery,
  2. Kenneth L Campbell, consultant colorectal surgeon
  1. Colorectal Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY
  2. Colorectal Unit, Ninewells Hospital and Medical School, Dundee DD1 9SY

Simple measures in primary care are often effective

Faecal incontinence is a major problem. A recent systematic review of theliterature shows a prevalence of 11-15% in the community.1 These figures have to be interpreted with caution because the relevant studiesare hampered by possible under-reporting and, more importantly, by a lack of a consensus definition. Incontinence of flatus, liquid stool, or solid stool that has an impact on quality of life is a practical definition,2 and here we summarise the management of this heterogeneous condition mostly from a primary care perspective but including possible surgical interventions.

Faecal incontinence has many causes and varies in severity from minor faecal soiling to frank incontinence of solid stool. When a patient presents with this symptom we need to establish the degree of debility and obtain an obstetric history.3 Inspection of the anal canal and digital rectal examination is essential. Anal skin tags associated with haemorrhoids can hinder adequate toilet, and poor …

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