Faecal incontinence.

Faecal incontinence is a disorder predominantly of the elderly. It is one of the more unpleasant consequences of failing health in old age, both for the sufferer and for the care giver. There are many potential colorectal and anal disorders capable of contributing to or causing faecal incontinence. However, in the elderly, there are two major causes: faecal loading and neurogenic incontinence. Rectal examination is mandatory for all patients with faecal incontinence as it allows the detection of local anorectal abnormalities (not only impaction or faecal loading) which may be responsible for the incontinence. With faecal impaction, there is a history of continuous faecal soiling in the presence of a loaded rectum and in neurogenic incontinence, there is the passage of formed stools with a normal rectal examination. Faecal incontinence imposes a heavy care burden. Often, faecal incontinence can be successfully treated. However, when intractable, continence nurse advisers are available to assist in the selection of suitable pads and underclothing.