When should I consider referring a patient with faecal incontinence to a specialist?

Consider referring a patient with faecal incontinence to a specialist continence service if initial management has failed or symptoms persist despite appropriate interventions ¹.

People with continuing faecal incontinence after conservative management should be considered for specialist assessment, including anorectal physiology studies, endoanal ultrasound, or other indicated tests ¹.

Patients with faecal incontinence that severely restricts lifestyle and for whom all appropriate non-surgical and surgical options have been considered may be offered referral for further management by a specialist surgeon ¹.

People with neurological or spinal disease/injury resulting in faecal incontinence who continue to have episodes after initial management should be referred for a neurological bowel management programme ².

People with confirmed severe cognitive impairment and ongoing faecal incontinence should be referred for a behavioural and functional analysis to determine if there is any behavioural reason for the incontinence ².