Consider referring a patient with faecal incontinence to a specialist continence service if initial management has failed or symptoms persist despite appropriate interventions NICE CKS.
People with continuing faecal incontinence after conservative management should be considered for specialist assessment, including anorectal physiology studies, endoanal ultrasound, or other indicated tests NICE CKS.
Patients with faecal incontinence that severely restricts lifestyle and for whom all appropriate non-surgical and surgical options have been considered may be offered referral for further management by a specialist surgeon NICE CKS.
People with neurological or spinal disease/injury resulting in faecal incontinence who continue to have episodes after initial management should be referred for a neurological bowel management programme NICE CG49.
People with confirmed severe cognitive impairment and ongoing faecal incontinence should be referred for a behavioural and functional analysis to determine if there is any behavioural reason for the incontinence NICE CG49.