COMMENTARY

Faecal incontinence affects > 1% of adults in the community and is associated with increased age, poor general health, limited physical activity, and diminished mental capacity.¹The prevalence, burden of illness, and social costs of faecal incontinence among community living adults is largely overlooked in comparison to the well documented problem of faecal incontinence in long term care institutions for the elderly.²Multiple reasons exist for dysfunction of the anal muscle tissue and damage to the anal sphincter³.

Bliss et al report the first randomised controlled trial of this topic, focusing on community living adults. The dietary fibre treatments were inexpensive, palatable, and easy to use over the counter products. Because of the complexity of the condition, information on individual causes and contributory comorbid factors would have been helpful in determining the generalisability of the study results. The small sample size further highlights the need for larger effectiveness trials before a change in clinical practice can be recommended. The authors also point out the need for longer term evaluation of the treatment's clinical usefulness and whether symptom improvements are sustained with long term management.

The study is relevant to nursing staff in acute care settings and the community, particularly those working with aged and aging populations. Simple measures are important among older adults where faecal incontinence is often treatable and preventable. The normalisation of faecal consistency and other conservative treatments such as relief of faecal impaction, increased mobility, and regular toileting can also help to relieve this condition⁴.

This is an important study that reinforces the need to more fully understand this chronic condition and to further explore simple but effective long term treatments.