Clinical geriatrics

Faecal incontinence in older people

Summary

Faecal incontinence in older people is a distressing and socially isolating symptom and increases the risk of morbidity, mortality and dependency. Many older individuals with faecal incontinence will not volunteer the problem to their general practitioner or nurse and, regrettably, health care providers do not routinely enquire about the symptom. Even when older people are noted by health care professionals to have faecal incontinence, the condition is often managed passively, especially in the long-term care setting where it is most prevalent. The importance of identifying treatable causes of faecal incontinence in older people, rather than just managing passively, is strongly emphasized in national and international guidance, but audit shows that adherence to such guidance is generally poor. This article describes epidemiology, causes, assessment, diagnosis and treatment of faecal incontinence in older people.

Keywords:Faecal incontinence; constipation; older people

Correspondence:

^c1 Address for correspondence: Dr Danielle Harari, Consultant Physician in Elderly Medicine, Department of Ageing and Health, 9th Floor, North Wing, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH. Email: Danielle.harari@kcl.ac.uk