Faecal incontinence is a disabling condition, with a high personal, social and economic cost. Whilst it may occur at any age, prevalence and severity of symptoms is higher among older people. There are many therapeutic options, ranging from non-invasive treatments to complex surgical techniques, with results that can be considered satisfactory in about 70% of individuals. A comprehensive study of the type of incontinence and its presentation and severity, together with consideration of the general condition of the patient and their environment, are the keys that will decide the best treatment option.

Faecal incontinence in older people is a distressing and socially isolating symptom and increases the risk of morbidity, mortality and dependency. Many older individuals with faecal incontinence will not volunteer the problem to their general practitioner or nurse and, regrettably, health care providers do not routinely enquire about the symptom. Even when older people are noted by health care professionals to have faecal incontinence, the condition is often managed passively, especially in the long-term care setting where it is most prevalent. The importance of identifying treatable causes of faecal incontinence in older people, rather than just managing passively, is strongly emphasized in national and international guidance, but audit shows that adherence to such guidance is generally poor. This article describes epidemiology, causes, assessment, diagnosis and treatment of faecal incontinence in older people.