Faecal incontinence: investigation, treatment and management

Faecal incontinence is a hidden problem that is often under-reported, under-diagnosed, under-investigated and under-treated. Faecal incontinence is more common in women and older people. Its prevalence also increases with age. Faecal incontinence occurs because of a complex interplay of contributing factors, some of which can be reversed in primary care without the need for specialist investigations and treatment. This article explores the reasons why adults develop faecal incontinence and how to identify and treat reversible causes in primary care. It also provides information on specialist treatment and the management of intractable faecal incontinence. A structured approach to assessment and management is key in identifying problems and offering primary care for timely treatment.