Faecal Incontinence

Question 1

What is the prevalence and age group of Faecal incontinence?

Answer 1

15% of 65+ yr olds

Question 2

What are the causes of Faecal incontinence? (7 things)

Answer 2

1. Sphincter weakness (after childbirth / surgery)
2. Anal / rectal pathology (fistula / Crohn’s)
3. Neuro (cauda equina)
4. Dementia
5. Diarrhoea
6. Constipation (esp in elderly / DM / hypothyroid)
7. Meds (abx / muscle relaxants / PPIs / Metformin)

Question 3

What investigations should you do for Faecal incontinence?

Answer 3

DRE / PE

Question 4

What is the point of DRE / PE in Faecal incontinence? (3 things)

Answer 4

1. Check sphincter function
2. Rule out impaction
3. Check perianal sensation (rule out neuro)

Question 5

What are the Mx options for Faecal incontinence caused by Sphincter issues? (2 things)

Answer 5

1. Perianal exercises (if sphincter weakness)
2. Surgery (for anal sphincter repair)

Question 6

What are some other Mx options for Faecal incontinence? (3 things)

Answer 6

1. Steroids / GTN gel (if anorectal pathology)
2. Bowel training (to develop predictable pattern)
3. TUC (diarrhoea / constipation)