A classification system for faecal incontinence based on anorectal investigations

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pelvic Floor Disorders

Background:

• Faecal incontinence (FI) is a significant cause of social disability affecting diverse patient populations.
• Current diagnostic and treatment approaches lack standardization, hindering outcome comparisons.
• A pretreatment classification is crucial for interpreting and comparing research findings.

Purpose of the Study:

• To review anorectal investigation findings in patients with defaecatory disorders.
• To propose a simple, repeatable classification system for faecal incontinence.

Main Methods:

• Retrospective analysis of 1159 patients undergoing anorectal investigations (February 2000–September 2006).
• Investigations included anorectal manometry, anal mucosal electrosensitivity testing, and endoanal ultrasonography.

Main Results:

• Four distinct groups of faecal incontinence were identified: traumatic, neuropathic, combined, and idiopathic.
• Significant differences in manometric variables and demographics were observed across these groups.
• 1159 patients (699 incontinent, 460 continent) were analyzed after exclusions.

Conclusions:

• Faecal incontinence patients can be categorized into groups with unique pathophysiological characteristics.
• This classification facilitates the comparison and interpretation of study outcomes.
• The proposed system aids in tailoring treatments to specific patient subgroups for better efficacy.