Faecal incontinence: the unvoiced symptom

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Physiology

Background:

• Diarrhea can be associated with fecal incontinence.
• Patients may not spontaneously report incontinence.
• Understanding the prevalence and underlying mechanisms of fecal incontinence in diarrhea patients is crucial.

Purpose of the Study:

• To determine the frequency of fecal incontinence in patients presenting with diarrhea.
• To investigate the relationship between fecal incontinence and anorectal function in these patients.
• To evaluate the utility of the saline infusion test in assessing anorectal dysfunction.

Main Methods:

• Prospective questioning of 76 consecutive gastrointestinal clinic patients with diarrhea regarding fecal incontinence.
• Measurement of anal-sphincter pressures (maximum squeeze pressures).
• Rectal saline infusion test to assess saline retention capacity.

Main Results:

• 51% of patients with diarrhea reported fecal incontinence, with less than half volunteering this information.
• Incontinent patients exhibited significantly lower anal-sphincter pressures compared to controls.
• Saline infusion tests revealed impaired rectal saline retention in incontinent individuals.

Conclusions:

• Fecal incontinence is a common, yet often unreported, symptom in patients with diarrhea.
• Actively screening for fecal incontinence is recommended as it may be the primary complaint.
• The saline infusion test is a simple and effective method for evaluating anorectal function disturbances.