Remember

• Minor forms of faecal incontinence are very common and not always reported by patients.
• A loss of anal sphincter function will ultimately manifest itself as uncontrolled bowel motions or urgency. The patient’s regularity and ability to cope often determine which symptom dominates.
• Patients who have faecal soiling but are confident about their ability to hold on to a bowel motion or flatus tend to have simple anal pathology (such as haemorrhoids) rather than a deficient anal sphincter.
• Most idiopathic faecal incontinence is due to pudendal neuropathy, which is often believed to have been acquired during childbirth.