Managing passive incontinence and incomplete evacuation.

Both passive faecal incontinence and evacuation difficulty are distressing and demoralising conditions, resulting in physical and psychological problems including social restrictions, loss of self-esteem, altered body image and loss of skin integrity. Conservative management and biofeedback therapy has been shown to help most patients with faecal incontinence and evacuation difficulty by creating a manageable situation that can significantly improve quality of life. However, some patients may not improve their symptoms and require alternative measures. This article reports an audit of the use of the Qufora mini irrigation system in 50 patients (48 female, 2 male) with passive faecal incontinence and/or evacuation difficulty who had failed to respond to conventional biofeedback. Seventy percent found the irrigation comfortable and 74% rated the system as good or acceptable. Two-thirds believed symptoms were improved and would wish to continue using the system. Prospective studies are needed to confirm which patients are most suitable and respond well to the irrigation.