incontinence of faeces

Last reviewed 01/2018

Incontinence of faeces is the involuntary passage of faeces. It is always abnormal, and nearly always curable.

  • NICE note that faecal incontinence is a sign or a symptom, not a diagnosis (1) - therefore, it is important to diagnose the cause or causes for each individual
    • no consensus on methods of classifying the symptoms and causes of faecal incontinence
    • most commonly classified according to symptom, character of the leakage, patient group or presumed primary underlying cause
    • little is known about the natural history of the condition but for some groups (such as women immediately after childbirth) there does seem to be some spontaneous resolution of symptoms
  • epidemiological information shows that between 1% and 10% of adults are affected with faecal incontinence, depending on the definition and frequency of faecal incontinence used. It is likely that 0.5-1.0% of adults experience regular faecal incontinence that affects their quality of life

Because faecal incontinence is a socially stigmatising condition, healthcare professionals should actively yet sensitively enquire about symptoms in high-risk groups:

  • frail older people
  • people with loose stools or diarrhoea from any cause
  • women following childbirth (especially following third- and fourth-egree obstetric injury)
  • people with neurological or spinal disease/injury (for example, spina bifida, stroke, multiple sclerosis, spinal cord injury)
  • people with severe cognitive impairment
  • people with urinary incontinence
  • people with pelvic organ prolapse and/or rectal prolapse
  • people who have had colonic resection or anal surgery
  • people who have undergone pelvic radiotherapy
  • people with perianal soreness, itching or pain
  • people with learning disabilities

Reference:

  1. NICE (2007).Faecal incontinence: the management of faecal incontinence in adults