Faecal incontinence in adults. 1: Prevalence and causes

Faecal incontinence is much more common in the general population than is often realized. Recent epidemiological work suggests that over 1% of all adults have some degree of faecal leakage. Although the problem increases with advancing age and disability, there are large numbers of otherwise healthy adults with this distressing symptom. Many, possibly the majority, do not seek professional help. The most common causes include childbirth by vaginal delivery, especially if assisted with forceps, any condition causing frequency or diarrhoea, and a variety of anorectal conditions. A detailed and empathic history taking, physical examination, and use of anorectal investigative techniques where indicated, enables an accurate individual diagnosis in most cases. A subsequent article will explore the treatment and management options once a diagnosis has been reached.