Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun;27(6):475-480.
doi: 10.1007/s10151-023-02778-2. Epub 2023 Mar 26.

Clinical characteristics of phenotypes of fecal incontinence

M E Knol  1   2 , E Bastiaannet  3 , M C DeRuiter  2 , H S Snijders  1 , J T M van der Heyden  1 , C I M Baeten  4
Affiliations

Clinical characteristics of phenotypes of fecal incontinence

M E Knol et al. Tech Coloproctol. 2023 Jun.

Abstract

Purpose: Fecal incontinence (FI) is common, but its etiology is complex with large knowledge gaps. Several phenotypes of FI are known, but the phenotype is often not decisive in the chosen therapy. In this study we aimed to assess the association of the clinical characteristics of patients with FI and the various phenotypes, in order to establish a targeted clinical treatment decision tree.

Methods: We retrospectively studied the charts of patients with FI, who visited our institute from January 2018 until December 2020. Patients were divided into the following groups: passive fecal loss, urge incontinence, combined fecal incontinence with predominantly passive fecal loss, and combined fecal incontinence with predominantly urge incontinence. We compared the characteristics between the passive and urge incontinence groups, the passive and combined mainly passive groups, and the urge and combined mainly urge groups.

Results: Patients with passive incintinence were older, more often had a flaccid anus with presence of a mucosal prolapse, and had a lower resting pressure on anorectal manometry. Patients with urge incontinence were younger and more often had a history of birth trauma. The combined groups showed characteristics of both of the main types of FI.

Conclusion: Differentiating into phenotypes of FI can be clinically meaningful. The patient history and clinical judgement of the consulting specialist, rather than the physical characteristics, seem to be decisive in the categorization. Additional diagnostic testing can be helpful in complicated cases, but should not be used routinely.

Keywords: Fecal incontinence; Phenotypes; Proctology; Surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Schedule of inclusion
See this image and copyright information in PMC

References

    1. Rao SS, Bharucha AE, Chiarioni G, Felt-Bersma R, Knowles C, Malcolm A et al (2016) Functional anorectal disorders. Gastroenterology 150(6):1430–1442.e4 - PMC - PubMed
    1. Simren M, Palsson OS, Whitehead WE. Update on Rome IV criteria for colorectal disorders: implications for clinical practice. Curr Gastroenterol Rep. 2017;19(4):15. doi: 10.1007/s11894-017-0554-0. - DOI - PMC - PubMed
    1. Bharucha AE, Dunivan G, Goode PS, et al. Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop. Am J Gastroenterol. 2015;110(1):127–136. doi: 10.1038/ajg.2014.396. - DOI - PMC - PubMed
    1. Ng KS, Sivakumaran Y, Nassar N, Gladman MA. Fecal incontinence: community prevalence and associated factors—a systematic review. Dis Colon Rectum. 2015;58(12):1194–1209. doi: 10.1097/DCR.0000000000000514. - DOI - PubMed
    1. Melenhorst J, Koch SM, Uludag O, van Gemert WG, Baeten CG. Is a morphologically intact anal sphincter necessary for success with sacral nerve modulation in patients with faecal incontinence? Colorectal Dis. 2008;10(3):257–262. doi: 10.1111/j.1463-1318.2007.01375.x. - DOI - PubMed

LinkOut - more resources