Fecal Incontinence - Diagnosis

Diagnosis

Diagnosis of FI usually begins with a thorough medical history, including detailed questioning about symptoms, bowel habits, diet, medication and other medical problems. This is usually followed by an examination. Depending upon the case, there are several types of procedure that may be included in the investigation of FI.

The Rome diagnostic criteria for functional fecal incontinence are:

• Recurrent uncontrolled passage of fecal material in an individual with a developmental age of at least 4 years and one or more of the following:
  • Abnormal functioning of normally innervated and structurally intact muscles
  • Minor abnormalities of sphincter structure and/or innervation
  • Normal or disordered bowel habits, (i.e., fecal retention or diarrhea)
  • Psychological causes

AND

• Exclusion of all the following:
  • Abnormal innervation caused by lesion(s) within the brain (e.g., dementia), spinal cord, or sacral nerve roots, or mixed lesions (e.g., multiple sclerosis), or as part of a generalized peripheral or autonomic neuropathy (e.g., due to diabetes)
  • Anal sphincter abnormalities associated with a multisystem disease (e.g., scleroderma)
  • Structural or neurogenic abnormalities believed to be the major or primary cause of fecal incontinence

* Criteria fulfilled for the last 3 months