Criteria
The following scales are designed to assess the severity of symptoms of fecal incontinence and the response to intervention. There are many in use, but these appear to offer reliability and validity.[28][29]
The Wexner Score
This score is easy to use and considers three types of incontinence (solid, liquid, and gas), the need to wear a pad, and lifestyle alteration. Frequency of each factor is given a score of 0 (never), 1 (rarely), 2 (sometimes), 3 (usually), or 4 (always).
The American Medical System Score
Patients are asked to recall symptoms over the preceding 4 weeks. Symptoms are classified by six frequencies: never, rarely, sometimes, weekly, daily, or several times daily. Scores are given based on five questions:
Did you experience accidental bowel leakage of gas?
Did you experience minor bowel soiling or seepage?
Did you experience significant accidental bowel leakage of liquid stool?
Did you experience significant accidental bowel leakage of solid stool?
Has this accidental leakage affected your lifestyle?
This scoring system has been used to assess the success of the neosphincter.
The Vaizey Score
This scoring system is similar to the Wexner Score but designed to include urgency and the need to use constipating medications. Incontinence to solid stool, liquid stool, and gas and lifestyle alteration are assessed. The frequency of each of these factors is given a score of 0 (never), 1 (rarely), 2 (sometimes), 3 (weekly), or 4 (daily). Additionally, patients are asked about the need to wear a pad or plug, the use of constipating medications, and the lack of ability to defer defecation for 15 minutes. A positive response scores 2 points each for the use of pads or constipating medication and 4 points for urgency.
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