Sbeit W, Khoury T, Mari A. Diagnostic approach to faecal incontinence: What test and when to perform? World J Gastroenterol 2021; 27(15): 1553-1562 [PMID: 33958842 DOI: 10.3748/wjg.v27.i15.1553]
Corresponding Author of This Article
Tawfik Khoury, MD, Doctor, Lecturer, Senior Researcher, Department of Gastroenterology, Galilee Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, POB 12000, Naharia 2210001, Israel. tawfikkhoury1@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 21, 2021; 27(15): 1553-1562 Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1553
Diagnostic approach to faecal incontinence: What test and when to perform?
Wisam Sbeit, Tawfik Khoury, Amir Mari
Wisam Sbeit, Tawfik Khoury, Department of Gastroenterology, Galilee Medical Center, Naharia 2210001, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
Amir Mari, Gastroenterology and Endoscopy Unit, The Nazareth Hospital, EMMS, Nazareth 464000, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
Author contributions: Sbeit W and Mari A contributed to the concept and design; All authors contributed to data collection and analyses; Sbeit W and Mari A wrote the first manuscript draft; Khoury T prepared the figures; All authors contributed to final writing of the manuscript and approved the final version to be published.
Conflict-of-interest statement: The authors declare no conflict of interest regarding this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tawfik Khoury, MD, Doctor, Lecturer, Senior Researcher, Department of Gastroenterology, Galilee Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, POB 12000, Naharia 2210001, Israel. tawfikkhoury1@hotmail.com
Received: December 7, 2020 Peer-review started: December 7, 2020 First decision: December 31, 2020 Revised: January 1, 2021 Accepted: March 17, 2021 Article in press: March 17, 2021 Published online: April 21, 2021 Processing time: 127 Days and 12.8 Hours
Abstract
Faecal incontinence (FI) is a debilitating common end result of several diseases affecting the quality of life and leading to patient disability, morbidity, and increased societal burden. Given the various causes of FI, it is important to assess and identify the underlying pathomechanisms. Several investigatory tools are available including high-resolution anorectal manometry, transrectal ultrasound, magnetic resonance imaging, and electromyography. This review article provides an overview on the causes and pathophysiology of FI and the author’s perspective of the stepwise investigation of patients with FI based on the available literature. Overall, high-resolution anorectal manometry should be the first investigatory tool for FI, followed by either transrectal ultrasound or magnetic resonance imaging for anal internal sphincter and external anal sphincter injury, respectively.
Core Tip: Faecal incontinence (FI) is a debilitating symptom, which causes severe disability that deeply affect patients’ quality of life. Given the various causes of FI, it is important for clinicians to recognize the available diagnostic investigatory tools and be familiar with the clinical approach for FI. Herein, we provide a concise overview of FI and recommend a stepwise algorithm for FI investigation.
