Instruments for the Assessment of Fecal and Anal Incontinence: A Scoping Review.

Area of Science:

• Gastroenterology
• Urology
• Gynecology
• Geriatrics
• Rehabilitation Medicine

Background:

• Fecal and anal incontinence (FI/AI) severely affects patients' physical, emotional, and social well-being.
• Accurate assessment tools are crucial for diagnosing, monitoring, and evaluating treatments for FI/AI.

Purpose of the Study:

• To conduct a comprehensive scoping review of available assessment tools for fecal and anal incontinence (FI/AI).
• To identify the characteristics, validation status, and scope of existing FI/AI assessment instruments.

Main Methods:

• A scoping review methodology based on Arksey and O'Malley's framework was employed.
• Searches were conducted across EMBASE, MEDLINE (PubMed), and PEDro databases up to February 2025.
• Studies focusing on the development, validation, or cross-cultural adaptation of FI/AI assessment tools were included.

Main Results:

• Fifty-two studies identified 52 distinct assessment instruments for FI/AI.
• The majority (65.4%) were self-administered questionnaires, primarily assessing quality of life.
• Few instruments reported complete psychometric validation or formal cross-cultural adaptation; fewer still assessed objective anorectal function.

Conclusions:

• While numerous FI/AI assessment tools exist, significant limitations persist.
• Gaps were identified in comprehensive functional evaluation, robust psychometric validation, and cross-cultural adaptation.
• Further development is needed to create more complete and validated instruments for FI/AI assessment.