Published online Aug 7, 2023. doi: 10.3748/wjg.v29.i29.4593
Peer-review started: April 27, 2023
First decision: June 7, 2023
Revised: June 9, 2023
Accepted: July 11, 2023
Article in press: July 11, 2023
Published online: August 7, 2023
Fecal incontinence (FI) is a common problem. Its assessment is difficult, and an objective scoring system needs to be developed so that FI can be evaluated uniformly all across the globe.
To develop a new effective, and scientifically sound scoring system in which the shortcomings of the existing scoring systems are removed.
The existing scoring systems had many lacunae, due to which they were not scientifically accurate.
A proforma was made in simple language in which all definitions of FI were included so that the study participants (patients and laypersons) could understand them. The study participants were then assigned disability scores (ranging from 0 to 100) for each type of FI based on a modified EQ-5D+ (EuroQol) descriptive system. The average score of each type of FI was calculated, divided by 10, and rounded off to determine the weight of each type. In the second phase of the study, a group of colorectal surgeons was asked to rank the six FI types in order of severity, and their ranking was compared with that of the patients and laypersons.
One hundred participants (50 patients and 50 laypersons) were included in the study. A new scoring system was formulated in which the maximum possible score was 80 (total incontinence), and the least 0 (no incontinence). The surgeons’ ranking of FI severity differed significantly from the patients’ and the laypersons’ rankings, highlighting that the surgeons and the patients may perceive the severity of different FIs differently.
A new scoring system for FI was formulated, which was simple, logical, comprehensive, and easy to use. The perceptions of patients and surgeons regarding the severity of different FIs differed significantly.
The new scoring system would be useful for clinicians worldwide to objectively assess FI in the clinical setting.