Version July 2025
| Questions to ask | Suggested diagnoses and comments |
| Confirm and categorize incontinence | |
| Is the patient truly incontinent or do they have frequency and urgency without incontinence? | Frequency and urgency without incontinence suggest:
|
| Does the patient have urgency? | Urge incontinence of loose/liquid stool suggests:
Passive incontinence of solid stool suggests:
|
| Does the patient have minor or major incontinence? | Larger amounts of leakage indicate a more severe defect in the continence mechanism |
| How long have symptoms been present? | Most fecal incontinence is chronic Acute symptoms are usually due to:
|
| Assess for alarm features | |
Does the patient have:
| Concern for acute neurologic condition; these include:
While uncommon, these warrant prompt imaging and evaluation |
Does the patient have:
| Concern for colorectal malignancy Expedited evaluation including colonoscopy is appropriate |
| Additional questions to help identify etiology and contributors | |
Does the patient have clear risk factors for fecal incontinence? These include:
| Patients without apparent risk factors may need more extensive evaluation to determine the etiology |
| Is there a background history of diarrhea? | Possible diagnoses include:
|
| Does the patient have a recent history of constipation? | Suggests diagnosis of fecal impaction Common causes of constipation include:
|
| Does the patient have a neurologic disturbance? | Possible diagnoses include:
|
| Does the patient have diabetes mellitus? | Suggests diabetic autonomic neuropathy |
| Is the patient on any medications that could be causing or contributing to incontinence? | Common medications include:
|
| Are there any dietary factors that could be contributing? | Specific dietary factors include:
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