Quality of Life Considerations on Fecal Incontinence

Abstract

Traditionally, it has been assumed that tests like anorectal manometry and endoanal ultrasound are essential in the evaluation of fecal incontinence (FI). However, in daily practice, this testing rarely helps in the decision-making, as are mainly based on the patient’s symptoms. Moreover, indications and outcome evaluation should not be decided by only considering the symptom severity but the impact on QoL and patient satisfaction. Nowadays, patients tend to be active consumers of health care, so they may participate on the medical decision-making. On the other hand, monitoring treatment results are mandatory in current practice. Finally, considering the cost of some of the current treatments for FI, changes in QoL should be demonstrated before implementing some procedures. For all these reasons, the QoL scales should be used, and readers encouraged to become familiar with QoL instruments and their limitations. The following chapter will cover almost all areas on existing knowledge about QoL in patients with FI: from how many types of QOL scales have been described, to the different ways to measure our patients’ satisfaction, passing through the difference between severity and QOL, going deep on if the improvement of patients treated for FI is reflected enough in the current used QOL scales.