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Rome IV Diagnostic Criteria for Fecal Incontinence

Diagnostic checklist for faecal incontinence in adults.

Rome IV Diagnostic Criteria for Fecal Incontinence
Developmental age ≥4 years
Recurrent uncontrolled passage of faecal material
Abnormal function of normally innervated and structurally intact pelvic-floor/anal-sphincter muscles
Minor abnormalities of anal sphincter structure and/or innervation
Normal or disordered bowel habits (faecal retention or diarrhoea)
Psychological cause(s) contributing
Criteria fulfilled for the last 3 months with symptom onset ≥6 months before diagnosis
ResultCriteria not met

Diagnosis requires recurrent uncontrolled passage of stool in a person of developmental age ≥4 years, associated with ≥1 of the listed contributing factors, for the last 3 months (onset ≥6 months prior).

Associated contributing factors
0 of 4

When to use

  • Characterising recurrent faecal incontinence and its likely contributing mechanism(s).

Formula

Recurrent uncontrolled passage of faecal material (developmental age ≥4 years) associated with ≥1 of: abnormal pelvic-floor/sphincter function, minor sphincter structural/innervation abnormality, disordered bowel habit, or psychological cause, present for the last 3 months with onset ≥6 months before diagnosis.

Pearls and pitfalls

  • Anorectal manometry, endoanal ultrasound, and defecography help identify the dominant mechanism and guide therapy.

References

  1. Rao SSC, Bharucha AE, Chiarioni G, et al. Functional Anorectal Disorders. Gastroenterology. 2016;150(6):1430-1442.