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Examination

Authoring team

General examination (as indicated)

Inspection (ask the patient to strain as if for stool), where the examiner is looking for:

  • inflammation
  • deformity
  • haemorrhoids
  • prolapse

Rectal examination:

  • anal tone, asking the patient to 'tighten up'
  • feel for faeces or tumour
  • examine for haemorrhoids which can be missed without proctoscopy

Abdominal examination:

  • feeling for colonic faecal loading

Neurological examination:

  • to assess for peripheral neuropathy
  • to assess mental state

NICE also suggest that an assessment of the patient's ability to use the toilet should be undertaken (1):

  • mobility
  • ability to adjust clothing
  • ability to wash after using toilet

Reference:

  1. NICE (2007).Faecal incontinence: the management of faecal incontinence in adults.

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