This calculator is for general information and education. It is not medical advice and does not replace the judgment of a doctor, nurse or pharmacist who knows the full clinical picture.
What the Wexner score measures
The Wexner score, also called the Cleveland Clinic Fecal Incontinence Score (CCFIS), was published in 1993 by Jorge and Wexner. It grades the severity of fecal (anal) incontinence with five questions, and it is the most widely used scale in colorectal surgery, pelvic floor physiotherapy and clinical trials. It takes about a minute to complete and is often filled in by the patient before a consultation and again after treatment.
The five items
Each item is rated by frequency:
| Score | Frequency |
|---|---|
| 0 | never |
| 1 | rarely: less than once a month |
| 2 | sometimes: less than once a week, at least once a month |
| 3 | usually: less than once a day, at least once a week |
| 4 | always: at least once a day |
The items are leakage of solid stool, leakage of liquid stool, leakage of gas, the need to wear a pad, and lifestyle alteration (avoiding outings, social activities or work). The total ranges from 0, perfect continence, to 20, complete incontinence.
Example
Rare solid leakage (1), occasional liquid leakage (2), usual gas leakage (3), occasional pad use (2) and rare lifestyle impact (1): total 9 out of 20. Leakage items alone account for 6 points.
Interpreting the score
There are no universal official bands. The ones shown here are used in several studies:
- 0: continent;
- 1 to 8: mild incontinence;
- 9 to 14: moderate, often with a clear impact on quality of life;
- 15 to 20: severe.
The score is most useful for tracking change in the same person, for example after pelvic floor exercises, biofeedback, dietary changes, sacral nerve stimulation or surgery. A drop of a few points is generally considered meaningful.
Limits
- It does not capture urgency, the inability to defer defecation for 15 minutes, which matters a lot to patients. The St Mark’s (Vaizey) score adds urgency and antidiarrheal drug use, on a 0 to 24 scale.
- It weights gas leakage the same as solid stool leakage.
- It does not identify the cause, such as an obstetric sphincter injury, nerve damage, chronic diarrhea or rectal prolapse.
Fecal incontinence is common, affecting about 1 in 12 adults, and it is often not reported out of embarrassment. Effective treatments exist, so a raised score is a good reason to talk to a doctor.