Faecal incontinence

Abstract

Faecal incontinence (FI) affects between 2 and 24% of the general population. It is a distressing problem that can lead to social isolation and stigmatisation. The most significant risk factor for the development of FI is obstetric injury via vaginal delivery in nulliparous women. Its incidence increases with advancing age and affects more women than men (4:1); however, women are more likely to present to their GP. It is thought that the true incidence of the condition is likely to be much higher if reluctance to consult is taken into account. FI is defined as: ‘The involuntary loss of flatus, liquid or stool that is a social or hygiene problem’ occurring for at least 1 month according to the International Continence Society. Treatment of FI and its symptoms places a considerable financial burden on the NHS – the cost exceeds the total combined cost of all cardiac and anti-inflammatory medications. This review summarises the diagnosis and management of FI, with an emphasis on the role of the primary care physician in its management. This common condition can often be managed successfully in the community and the GP plays a key role in this process.