Treatments of faecal incontinence: recommendations from the French national society of coloproctology

Colorectal Dis. 2014 Mar;16(3):159-66. doi: 10.1111/codi.12410.

Abstract

Faecal incontinence is common and significantly affects quality of life. Its treatment involves dietary manipulation, medical treatments, perineal rehabilitation or surgery. In this paper, the French National Society of Coloproctology offers recommendations based on the data in the current literature, including those on recently developed treatments. There is a lack of high quality data and most of the recommendations are therefore based either on grade of recommendation B or expert recommendation (Level 4). However, the literature supports the construction of an algorithm based on the available scientific evidence and expert recommendation which may be useful in clinical practice. The French National Society of Coloproctology proposes a decision-making algorithm that includes recent developments of treatment. The current recommendations support sacral nerve modulation as the key treatment for faecal incontinence. They do not support the use of sphincter substitutions except in certain circumstances. Transanal irrigation is a novel often successful treatment of faecal incontinence due to neurological disorders.

Keywords: Faecal incontinence; coloproctology; national recommendations.

Publication types

  • Practice Guideline

MeSH terms

  • Anal Canal / surgery*
  • Antidiarrheals / therapeutic use*
  • Cholestyramine Resin / therapeutic use
  • Diet Therapy / methods*
  • Dietary Fiber / therapeutic use
  • Electric Stimulation Therapy / methods*
  • Evidence-Based Medicine
  • Exercise Therapy / methods*
  • Fecal Incontinence / therapy*
  • Humans
  • Loperamide / therapeutic use
  • Lumbosacral Plexus
  • Plant Mucilage / therapeutic use
  • Therapeutic Irrigation / methods
  • Tibial Nerve
  • Treatment Outcome

Substances

  • Antidiarrheals
  • Dietary Fiber
  • Plant Mucilage
  • Cholestyramine Resin
  • Loperamide