Faecal incontinence: what influences care and management options?

Since the development of guidelines for faecal incontinence in adults by the National Institute for Health and Clinical Excellence guidelines in June 2007, there now appears to be more of a focus in primary and secondary care on the management patients with faecal incontinence. Faecal incontinence has a devastating effect on peoples quality of life but they often do not seek help due to the embarrassing and taboo nature of the problem. Therefore, it is essential that the healthcare professional who they eventually approach have the skills, knowledge and experience to undertake a thorough clinical assessment, establish a cause, and initiate an individualized management plan. This article discusses the prevalence, definition and guidelines that influence the care given to patients with faecal incontinence. It focuses on the importance of good assessment to establish a differential diagnosis, initial management and then specialist management, including surgical options. Faecal incontinence is a symptom, not a disease, and with good management these symptoms are amenable to treatment.