Faecal Incontinence

Question 1

Faecal incontinence is almost always abnormal. True or false?

Answer 1

True

Question 2

What percentage of care home residents are incontinent of faeces?

Answer 2

10%

Question 3

What is the most common cause of faecal incontinence?

Answer 3

Faecal impaction with overflow diarrhoea - accounts for 50%

Question 4

What is the second most common cause of faecal incontinence?

Answer 4

Neurogenic dysfunction

Question 5

Why are older people more at risk?

Answer 5

As the body ages the rectum becomes more vacuous and the anal sphincter can gape due to a number of factors e.g haemorrhoids and chronic constipation

Older people can not exert the same intra abdominal pressure and muscle tension to force out constipated stool

Question 6

Is it normal for faeces to be in the rectum at any time?

Answer 6

No unless passing stool

Question 7

Diminished anal tone and sensation suggests what?

Answer 7

Spinal cord pathology

Question 8

What assessment is necessary?

Answer 8

PR examination

Assess faeces, rectum, prostate, tone and sensation, visual inspection

Question 9

What should raise suspicion of impaction of overflow?

Answer 9

Smearing, small amount of type 1, copious type 6/7 with no sensation of defaecation

Question 10

Can faecal impaction kill?

Answer 10

Yes

Risk of perforation and ischaemic bowel in those who are chronically constipated

Question 11

How should constipation be managed?

Answer 11

Manual evacuation
Enemas
Laxatives