Wexner Incontinence • CCFIS Profile
| Domain | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Solid Incontinence | |||||
| Liquid Incontinence | |||||
| Gas Incontinence | |||||
| Wears a Pad | |||||
| Lifestyle Alteration |
Select the frequency for each incontinence domain to visualize the cumulative Wexner CCFIS index.
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Assessment of Fecal Incontinence (FI) severity
To guide the triage for surgical interventions (e.g., Sphincteroplasty or Sacral Nerve Stimulation)
Measuring the therapeutic impact of biofeedback or dietary changes
Standard of Care
The Wexner Incontinence Score is the most widely used tool globally for quantifying accidental bowel leakage. It is simple, reproducible, and focuses on the "Social" impact of the disease.
How it Works
The 5 Incontinence Items
01
Solid Incontinence (Frequency).
02
Liquid Incontinence (Frequency).
03
Gas (Flatus) Incontinence (Frequency).
04
Pad (Protection) use frequency.
05
Lifestyle Alteration (Frequency of missed social/work events).
Frequency Scoring (0–4 pts each)
| Never | 0 Points |
| Rarely (< 1/month) | 1 Point |
| Sometimes (< 1/week) | 2 Points |
| Usually (≥ 1/week) | 3 Points |
| Always (Daily) | 4 Points |
Total Interpretation (0–20)
0 = Perfect Continence. 20 = Complete Incontinence.
Clinical Pearls
Why Gas Matters
Inability to control flatus (Gas) is often the earliest sign of internal anal sphincter (IAS) weakness. While patients may find it "minor," high gas-incontinence scores are highly predictive of progress to liquid and solid failure over time.
The Lifestyle Weight
The "Lifestyle" domain captures the psychological burden of fecal incontinence. A patient with a score of 8 where 4 points come from lifestyle changes is often more desperate for intervention than a patient with a score of 10 who maintains normal social activities.
Clinical Pearls
A score ≥ 9 is typically considered "Moderate-to-Severe" incontinence
Post-partum patients often score high in the first 3 months; re-evaluation at 6 months is recommended to distinguish transient trauma from permanent injury
The score does not differentiate between "Urge" and "Passive" incontinence; this requires Anorectal Manometry
Next Steps
Management Decisions
01
Score > 9: Complete workup with Endoanal Ultrasound (rule out sphincter tear) and Manometry.
02
Score < 5: Fiber supplementation and Loperamide trial.
Complementary Scoring
St. Mark's (Vaizey) Score (Adds Urgency)
ARM Interpreter
Fecal Incontinence Quality of Life (FIQL) Scale
The Evidence
The Foundational Score
Etiology and management of fecal incontinence.
Jorge JM et al. • Diseases of the Colon & Rectum. 1993;36(1):77-97. The seminal description of the incontinence scale.
View Source• . ;
Origins & History
Jorge & Wexner
Developed by Lucia Jorge and Steven Wexner at the Cleveland Clinic Florida. It has withstood the test of time (30+ years) and remains the most cited instrument in colorectal surgical literature.
Last Comprehensive Review: 2026-07-17