New objective scoring system to clinically assess fecal incontinence

Area of Science:

• Gastroenterology and Colorectal Surgery
• Patient-Reported Outcome Measures
• Health Assessment Tools

Background:

• Existing fecal incontinence (FI) scoring systems, such as Wexner and Vaizey, have limitations in accuracy and comprehensiveness.
• There is a need for improved methods to quantify the impact of FI on patients' lives.

Purpose of the Study:

• To develop a novel scoring system for fecal incontinence (FI) that is accurate, comprehensive, and user-friendly.
• To incorporate patient and layperson perspectives in quantifying the disability associated with different types of FI.

Main Methods:

• A new scoring system was developed using patient and layperson disability scores for six types of FI (solid, liquid, flatus, mucus, stress, urge).
• Weights for each FI type were determined by averaging disability scores assessed using a modified EQ-5D+ system.
• Frequency of FI episodes was categorized (never, occasional, common) to calculate a final score.

Main Results:

• A new FI scoring system was formulated with a maximum score of 80, assigning weights to different FI types (e.g., solid/liquid-8, urge-7, flatus/mucus-6, stress-5).
• Patient and layperson rankings of FI severity differed from colorectal surgeons' rankings.
• The study identified a discrepancy in how healthcare providers and patients perceive the severity of fecal incontinence.

Conclusions:

• A new, simple, logical, and comprehensive scoring system for fecal incontinence (FI) has been developed, addressing shortcomings of previous methods.
• The developed system is easy to use and provides a more accurate assessment of FI.
• Significant differences were observed between patients' and surgeons' perceptions of FI severity.