Registered Nurses' Association of Ontario

Practice Considerations for Assessment of Fecal Incontinence

  • Understand the subtypes of fecal incontinence experienced (i.e., passive fecal incontinence, urge fecal incontinence or functional fecal incontinence).
  • Identify a list of risk factors for fecal incontinence
  • Obtain history on the following
    • Daily bowel habits—including frequency and stool consistency, as well as the onset, duration and severity of symptoms—to understand the type of fecal incontinence.
    • Information regarding the timing of fecal incontinence (e.g., post-defecation or during the night) to evaluate if fecal incontinence is associated with a bowel movement.
    • Dietary history, to rule out possible underlying causes.
    • Medications, to evaluate the effect on fecal incontinence.
    • Co-morbid conditions, to determine possible underlying causes.
    • Obstetric history, to rule out fecal incontinence associated with the use of forceps, birth weight greater than 4 kg or a fourth-degree tear. 52
    • Previous surgeries (e.g., anal fissure surgery or fistula surgery), pelvic radiation or other pelvic floor problems (e.g., urinary incontinence or pelvic organ prolapse) that may contribute to fecal incontinence.
    • Impact of fecal incontinence on quality of life

To view practice notes from expert panel click here

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