Rockwood et al developed the Fecal Incontinence Severity Index (FISI) to describe the severity of different types of incontinence for bowel contents. This can be monitored over time to evaluate the response to various interventions. The authors are from the University of Minnesota in Minneapolis.
Types of incontinence:
(1) gas
(2) mucus
(3) liquid stool
(4) solid stool
Frequency of incontinence:
(1) never
(2) 1 to 3 times per month
(3) once a week
(4) 2 or more times per week but not daily
(5) once a day
(6) 2 or more times per day
The more severe the incontinence the higher the points assigned up to a potential maximum of 20.
|
Parameter |
Finding |
Points |
|
incontinent to gas |
never |
0 |
|
|
1 to 3 times per month |
4 |
|
|
1 time per week |
6 |
|
|
2 or more times per week |
8 |
|
|
1 time per day |
11 |
|
|
2 or more times per week |
12 |
|
incontinent for mucus |
never |
0 |
|
|
1 to 3 times per month |
3 |
|
|
1 time per week |
5 |
|
|
2 or more times per week |
7 |
|
|
1 time per day |
10 |
|
|
2 or more times per week |
12 |
|
incontinent for liquid stool |
never |
0 |
|
|
1 to 3 times per month |
8 |
|
|
1 time per week |
10 |
|
|
2 or more times per week |
13 |
|
|
1 time per day |
17 |
|
|
2 or more times per week |
19 |
|
incontinent for solid stool |
never |
0 |
|
|
1 to 3 times per month |
8 |
|
|
1 time per week |
10 |
|
|
2 or more times per week |
13 |
|
|
1 time per day |
16 |
|
|
2 or more times per week |
18 |
where:
• The point assignment is based on Table 1 (patient responses), page 1527.
total FISI =
= SUM(points for all 4 types of incontinence)
Interpretation:
• minimum FISI: 0
• maximum FISI: 61
• The higher the FISI the more severe the fecal incontinence.
• Cavanaugh et al found that a FISI > 30 was associated with an impaired quality of life.
Specialty: Gastroenterology
