Selecting patients with faecal incontinence for anal sphincter  surgery: the influence of irritable bowel syndrome.
OBJECTIVE
This was a prospective study to determine the prevalence of irritable bowel syndrome (IBS) in patients with faecal incontinence and to investigate the association of IBS positivity with sphincter dysfunction.


METHODS
Patients with faecal incontinence were referred for physiological assessment and further management. Those with an acute obstetric injury, rectal prolapse or previous anorectal surgery were excluded. One hundred and seventy-seven women were studied. Symptom questionnaires were used prospectively to identify IBS positivity using Rome 11 criteria and the Cleveland Clinic incontinence score.


RESULTS
The prevalence of IBS was 44%. IBS patients had higher incontinence scores than non-IBS patients (11.0 vs 9.0, P < 0.01). A normal or high maximum resting anal pressure in an incontinent woman increased the chance of her having IBS by a factor of 2.6.


CONCLUSIONS
The prevalence of IBS positivity in patients presenting with faecal incontinence was high. A normal or high anal resting pressure and a high incontinence score should raise the suspicion of IBS.
Chaudhary
B N
BN
North Bristol Trust, Beckspool Road, Frenchay, Bristol, UK.
Chadwick
M
M
Roe
A M
AM
D001003:Anal Canal / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005242:Fecal Incontinence / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000453:epidemiology*; D008365:Manometry; D018579:Patient Selection; D015995:Prevalence; D011446:Prospective Studies; D018709:Statistics, Nonparametric