Information for the public

Finding out what is wrong

Finding out what is wrong

People at risk

There are certain groups of people who are more likely to have faecal incontinence than others. Healthcare professionals should ask people (or their carers) whether they experience faecal incontinence if they are in one of the following groups:

  • frail older people

  • people with loose stools or diarrhoea

  • women who have recently given birth

  • people who have injury to or disease of their nervous system or spinal cord

  • people with learning disabilities or memory problems

  • people with urinary incontinence

  • people who have had a prolapse of their rectum or organs in their pelvis (this means that these organs have slipped down from their usual position in the body)

  • people who have had an operation on their colon (part of the bowel) or anus

  • people who have had radiotherapy to their pelvic area

  • people with soreness or itching around the anal area.

Preventing problems with incontinence

Healthcare professionals should consider offering help with bowel management to the following groups of people, to help prevent problems with incontinence:

  • people who have a disease or injury of their brain, nerves or spine

  • people with limited mobility (who cannot get to the toilet easily)

  • people with constipation or faecal loading (there is more information about this in Advice for specific groups of people)

  • people in hospital who develop short-term faecal loading and incontinence

  • people with learning disabilities or memory problems.

Assessing faecal incontinence

Faecal incontinence can have many different causes. Your healthcare professional should first carry out a full assessment of your condition to ensure you get the most appropriate treatment. This is known as a 'baseline assessment' and should include asking about your medical history. Some examples of questions you may be asked are given below.

Examples of questions you may be asked

  • When/how often do you usually empty your bowels? Has this changed recently?

  • Have you had any bleeding?

  • Do you need help using or getting to the toilet?

  • What medicines are you taking, including those bought from a chemist?

  • How much fluid do you drink each day?

  • What types of food do you eat?

  • Do you experience itching or soreness around your anus?

  • How do your symptoms affect your daily life?

Your healthcare professional should ask permission to examine your anus and rectum.

Dealing with faecal incontinence

As part of your assessment, you should be given help and advice to help you deal with your incontinence. Your healthcare professional should tell you about continence products available and how to use them, including disposable pads. You should be offered a choice of pad styles and given enough pads for your needs. You may also be offered anal plugs (to insert in the anus to prevent leakage of faeces) if they are suitable for you.

Your healthcare professional should give you advice about how to clean and protect your skin, to stop it getting sore. You should be offered advice on odour control and how to deal with your laundry.

Your healthcare professional should give you information about emotional support, and counselling if you need it.

If you need to travel, you should be given advice on how to plan journeys so that you can use public toilets. You should also be told about a toilet access card and a RADAR key. The toilet access card is a small card you can carry that explains that you have a medical condition that means you need to use the toilet urgently. The RADAR key allows you to use 'disabled' toilets in the National Key Scheme. For more information see www.radar-shop.org.uk/Detail.aspx?id=0