Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1553
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
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.