Abstract
A grading system of anal incontinence (AI) is described that takes into account both degree and frequency of symptoms. A, B, and C indicate AI for flatus/mucus, liquid stool, and solid stool, respectively; 1, 2, and 3 indicate occasional, weekly, and daily AI. A scoring system, ranging from 0 (continence) to 6 (severe AI,i.e.,daily AI for solid stool or C3) also is reported. Three hundred thirty-five patients have been evaluated by this method in our institution: 30 percent had severe AI, graded as C3; only 9 percent had mild symptoms graded as A. Both males and females could not control diarrhea (Grade B) in 44 percent of cases. Nearly half of the 110 patients who underwent surgery had a C3 incontinence before treatment. Positive results were achieved in 75 percent of cases after surgery:e.g.,AI score significantly improved from 4.2±1.6 to 1.5±1.9 (P <0.001) in those with AI and rectal prolapse. Most of the failures were the patients with idiopathic C3 incontinence. In conclusion, this grading and scoring system allowed a satisfactory assessment of patients' AI before and after treatment. It may also be used to achieve an objective comparison between different series.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Pescatori M, Mattana C, and the Italian Registry of ileoanal reservoir. Factors affecting anal continence after restorative proctocolectomy. Int J Colorectal Dis 1990;5:213–8.
Keighley MR, Fielding WL. Management of faecal incontinence and results of surgical treatment. Br J Surg 1983;70:463–8.
Womack NR, Morrison JF, Williams NS. Prospective study of the effects of postanal repair in neurogenic fecal incontinence. Br J Surg 1988;75:48–52.
Kelly JH. Cineradiography in anorectal malformation. J Pediatr Surg 1968;4:538.
Parks AG. Anorectal incontinence. J R Soc Med 1975;68:21–30.
Lane RN. Clinical application of anorectal physiology. Proc Soc Med 1975;68:28–30.
Rudd WW. The transanal anastomosis: a sphincter-saving operation with improved continence. Dis Colon Rectum 1979;22:102–5.
Holschneider AM. Treatment and functional results of anorectal continence in children with imperforated anus. Acta Chir Belg 1983;3:191–204.
Corman M. Gracilis muscle transposition for anal incontinence. Late results. Br J Surg 1985;72:S21–2.
Hiltunen KM, Matikainen M, Auvinen O, Hietanen P. Clinical and manometric evaluation of anal sphincter function in incontinent patients. Am J Surg 1986;151:489–92.
Broden G, Dolk A, Holmstroem B. Recovery of the internal anal sphincter following rectopexy: a possible explanation for continence improvement. Int J Colorectal Dis 1988;3:23–8.
Rainey JB, Donaldson DN, Thomson JP. Postanal repair: which patients derive most benefit? J R Coll Surg Edinb 1990;35:101–5.
Miller R, Bartolo DC, Lock-Edmunds JC, Mortensen NJ. Prospective study of conservative and operative treatment for faecal incontinence. Br J Surg 1988;75:101–5.
Author information
Authors and Affiliations
About this article
Cite this article
Pescatori, M., Anastasio, G., Bottini, C. et al. New grading and scoring for anal incontinence. Dis Colon Rectum 35, 482–487 (1992). https://doi.org/10.1007/BF02049407
Issue Date:
DOI: https://doi.org/10.1007/BF02049407