Classification and causes
There is no universally agreed consensus on how faecal incontinence should be classified. This reflects the fact that the exact pathological changes are not fully understood and that in many cases there are a number of contributory causes.
The causes (anatomical and physiological) can be considered under three main headings:
- Disorders of the anus and rectum - sphincter laxity or damage, severe haemorrhoids, rectal prolapse, tumour & constipation.
- Faecal urgency – any cause of diarrhoea, or constipation with spurious diarrhoea (diarrhoea occurring as a result of constipation, when liquid faeces leak around a hard mass of faeces lodged in the rectum).
- Disorders of neurological control of the ano-rectal muscles and anal sphincter – for example, spinal cord injury, spina bifida, dementia nerve damage in childbirth.
High-risk groups for faecal incontinence include:
- Frail older people
- People with loose stools or diarrhoea
- People with neurological diseases such as spina bifida, stroke, multiple sclerosis, spinal cord injury, Parkinson’s disease etc
- People with cognitive impairment e.g. dementia, severe brain injury
- People with learning disabilities
- People with urinary incontinence
- People with vaginal and/or rectal prolapse
- People who have had bowel, anal or pelvic surgery
- People who have had pelvic radiotherapy (+/- surgery) for malignant disease
- Women following prolonged or complicated childbirth
Amended April 2008
