Holschneider developed a score to grade anorectal incontinence based on clinical and manometric findings. This can be used to evaluate the patient initially and to monitor the effectiveness of interventions. The author is from the University of Munich.
Parameters:
(1) stool frequency
(2) stool consistency
(3) fecal soiling
(4) sensibility (discrimination between solid, liquid, and gaseous stools)
(5) anorectal pressure profile
(6) squeeze pressure
(7) adaptation reaction
|
Parameter |
Finding |
Points |
|
stool frequency |
normal (1 to 2 times per day) |
2 |
|
|
often (3 to 5 times per day) |
1 |
|
|
very often (>= 6 times per day) |
0 |
|
stool consistency |
normal |
2 |
|
|
mushy |
1 |
|
|
liquid |
0 |
|
fecal soiling |
none |
2 |
|
|
under stress, with diarrhea |
1 |
|
|
always |
0 |
|
sensibility |
good discrimination (normal) |
2 |
|
|
no discrimination (urgency) |
1 |
|
|
missing |
0 |
|
anorectal pressure profile |
20 - 24 mm Hg |
2 |
|
|
14 - 19 mm Hg |
1 |
|
|
<= 13 mm Hg |
0 |
|
squeeze pressure |
>= 30 mm Hg |
2 |
|
|
20 - 29 mm Hg |
1 |
|
|
<= 19 mm Hg |
0 |
|
adaptation reaction |
normal |
2 |
|
|
irregular |
1 |
|
|
missing |
0 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• The lower the score the worse the fecal incontinence.
|
Total Score |
Interpretation |
|
0 to 4 |
incontinent |
|
5 to 8 |
improved |
|
9 to 11 |
satisfactory |
|
12 to 14 |
good |
Specialty: Gastroenterology
