Evaluation of faecal incontinence scores

Aims: Clinical severity is the main determinant of treatment outcome in faecal incontinence, however embarrassment may prevent accurate assessment of symptomatology. We compared patient-administered and physician-administered faecal incontinence questionnaires to estimate the effect of mode of administration on results.

Methods: The Wexner, Pescatori and Vaizey scores were evaluated. 100 randomly selected patients attending the colorectal outpatient department and 25 patients attending for management of faecal incontinence completed two faecal incontinence questionnaires, one self-administered and one physician-administered. Patients were randomly allocated to physician-administration or self-administration first.

Results: In randomly selected outpatients the median score for the three questionnaires was zero and there was no difference between the patient-administered and physician-administered scores. The majority of patients attending with faecal incontinence had higher scores on the self-administered questionnaire (Pescatori 65%, Vaizey 56%, Wexner 52%) and this was not affected by order of administration. There was no significant difference in mean total score for each questionnaire (Pescatori 11.4 vs. 9.2, Vaizey 12.8 vs. 12, Wexner 9.2 vs. 9.6).

Conclusions: We found that physician-administered questionnaires tended to underestimate the severity of faecal incontinence. This may affect treatment selection and outcome.