A classification system for faecal incontinence based on anorectal investigations

Br J Surg. 2008 Feb;95(2):222-8. doi: 10.1002/bjs.5933.

Abstract

Background: Faecal incontinence is a socially disabling condition that affects a heterogeneous population of patients. There is no standardization of investigations, and treatment outcomes are variable. The major limitation for comparing the results from different studies is the lack of a pretreatment classification of incontinence. The aim of this study was to review the anorectal investigation findings and propose a simple, repeatable classification for faecal incontinence.

Methods: Patients who had anorectal investigations for defaecatory disorders from February 2000 to September 2006 were analysed retrospectively. All patients had anorectal manometry, anal mucosal electrosensitivity testing and endoanal ultrasonography.

Results: Of a total of 1294 patients, 135 were excluded, leaving 1159 (460 continent and 699 incontinent) for analysis. The patients were divided into four groups: traumatic incontinence, neuropathic faecal incontinence, combined faecal incontinence and idiopathic faecal incontinence. The manometric variables and demographics were distinct in these groups.

Conclusion: Patients with faecal incontinence can be classified into different groups with distinct pathophysiological variables. Such a classification system will enable comparison and interpretation of the outcomes of different studies and also help in the selection of patients for appropriate treatments.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anal Canal / physiopathology*
  • Anus Diseases / diagnostic imaging
  • Anus Diseases / physiopathology*
  • Electrophysiology / methods
  • Fecal Incontinence / classification*
  • Fecal Incontinence / diagnostic imaging
  • Fecal Incontinence / physiopathology
  • Female
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Pressure
  • Retrospective Studies
  • Sensation / physiology
  • Treatment Outcome
  • Ultrasonography