Examination

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.