Rome IV Diagnostic Criteria for Faecal Incontinence
Rome IV criteria for diagnosing faecal incontinence in adults (age >= 4 years). The recurrent uncontrolled passage of faecal material in adults with developmentally appropriate toileting skills.
Score interpretation
Faecal incontinence criteria not fully met -- assess for structural causes
→ Colorectal examination (DRE, proctoscopy); anorectal physiology; endo-anal ultrasound; colonoscopy if mucosal cause suspected; treat underlying cause if identified (IBD, prolapse, haemorrhoids, fistula).
Rome IV faecal incontinence confirmed -- structured management programme
→ Conservative measures first: bowel habit training (regular toileting post-meals -- gastrocolic reflex); dietary modification (identify and avoid triggers); pelvic floor physiotherapy (biofeedback); stool consistency optimisation: loperamide 2 mg 30 min before meals for loose stools (most effective pharmacological intervention); if constipated + overflow: treat constipation (lactulose + polyethylene glycol); anorectal physiology (manometry, pudendal nerve latency, endo-anal USS); anal irrigation (Peristeen system -- for neurogenic FI); sacral nerve stimulation (SNS/SNM -- NICE-approved: effective for internal sphincter damage, neurogenic FI, idiopathic); sphincteroplasty if external sphincter defect on ultrasound (trauma-related -- obstetric tears); PTNS (percutaneous tibial nerve stimulation); specialist colorectal MDT; psychological support; continence nurse specialist; quality of life assessment.
Interpretation bands for the Rome IV Faecal Incontinence. Apply clinical judgement and local guidance.
References
- Bharucha AE et al. Functional defecation disorders. Gastroenterology. 2016;150(6):1430-1442.
- NICE TA387. Sacral nerve stimulation for faecal incontinence. NICE. 2011.
Related
Curated clinical cross-links plus same-class fallbacks.
- Manning Criteria for Irritable Bowel Syndrome · Functional GI Disorders
- Kruis Score for Diagnosis of Irritable Bowel Syndrome · Functional GI Disorders
- Rome IV Diagnostic Criteria for Functional Dyspepsia · Functional GI Disorders
- Rome IV Diagnostic Criteria for Functional Constipation · Functional GI Disorders
- Rome IV Diagnostic Criteria for Functional Chest Pain · Functional GI Disorders
- Rome IV Diagnostic Criteria for Globus · Functional GI Disorders
- Docusate Sodium · Faecal Softener / Stimulant Laxative
- Sodium Picosulfate · Stimulant Laxative / Bowel Preparation Agent
- Citric acid · Bowel preparation component
- Citric acid with magnesium carbonate · Osmotic bowel cleanser
- Macrogol 3350 with sulfate, ascorbate, KCl & NaCl (bowel prep) · Osmotic bowel cleanser
- Macrogol 3350 with KCl/NaHCO3/NaCl · Osmotic bowel cleanser
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.