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Faecal incontinence after obstetric injury — ESEGH MCQ

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HardLuminal GIFaecal incontinence after obstetric injuryESEGH

A 58-year-old woman has faecal urgency and passive leakage after a third-degree obstetric tear many years ago. Rectal examination shows reduced squeeze pressure. Colonoscopy is normal and stool consistency has improved with fibre. What is the most appropriate investigation?

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Correct answer: B — Anorectal physiology with endoanal ultrasonography

The best answer is “Anorectal physiology with endoanal ultrasonography”. Anorectal physiology testing with endoanal ultrasound The alternatives “ERCP, after multidisciplinary assessment”, “Liver biopsy, when clinically appropriate”, “SeHCAT scan as the sole test”, “Capsule endoscopy, within a guideline-based pathway” are plausible in related gastroenterology presentations but do not match the defining finding, threshold, sequence or UK pathway in this stem.

Reference: BSG and ESGE endoscopy guideline: https://gut.bmj.com/content/70/9/1611