Management of faecal incontinence in adults: summary of NICE guidance

Abstract

The prevalence of faecal incontinence in adults living in the community is 1-10%, depending on the definition used. 1 2 Faecal incontinence is a neglected problem that receives limited medical attention, and despite its profound negative impact most patients do not tell their doctor about it. 3 4 Simple, low cost interventions will often improve or even cure symptoms. More sophisticated second line investigations and treatments are available, but referral for these is not common. This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) on managing faecal incontinence in adults. 5 Recommendations NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, a range of consensus techniques is used to develop recommendations. In this summary, recommendations derived primarily from consensus techniques are indicated with an asterisk (*). General approach All staff working with people with faecal incontinence should be aware of the physical and emotional impact this condition can have on patients and their carers. Consider patients' needs and preferences when planning treatment and ensure they have the opportunity to make informed decisions in partnership.

Effects of age and gender on three-dimensional endoanal ultrasonography measurements: development of normal ranges

“…It represents a major public health issue [1][2][3] as well as one that is likely to increase with a proportionally older population [4]. In tertiary referral practice, investigation of the patient with FI includes clinical (symptom severity and examination), physiological and radiological (structural) assessments, with the primary aetiological factor most commonly being compromised anal sphincter function [5].…”

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