Diagnostic approach to faecal incontinence: What test and when to perform?

Figure 1 High-resolution anorectal manometry demonstrating normal resting and squeeze anal pressures. Supplied from the Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel.

Figure 2 High-resolution anorectal manometry demonstrating low resting anal pressure (black arrow) and low squeeze pressure (orange arrow). Supplied from the Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel.

Figure 3 Normal internal and external anal sphincters (internal anal sphincter and external anal sphincter). Supplied from the Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel. EAS: External anal sphincter; IAS: Internal anal sphincter.

Figure 4 Internal anal sphincter atrophy manifested as sphincter thinning. Supplied from the Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel. EAS: External anal sphincter; IAS: Internal anal sphincter.

Figure 5 External anal sphincter tear. Supplied from the Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.

Figure 6 Stepwise approach of faecal incontinence investigation. EMG: Electromyography; MRI: Magnetic resonance imaging; TRUS: Trans-rectal ultrasound.