Continence Norm Gram

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The Equation
Flow Index calculator
Flow Index & contispation
Defecation Norm Gram
Anal Incontinence
Continence Norm Gram
Applications of the Theory
Facts and Controversies




  • 5 Curves were calculated and subsequently plotted on the norm gram:
    • Barium Sulphate Continence Curve (Upper solid curve)
    • Water Continence Curve (middle solid curve)
    • Barium Sulphate Soiling Curve (Upper dashed curve)
    • Water Soiling Curve (lower dashed Curve)
    • Air Continence Curve (Lower Solid Curve)


The above mentioned curves divide the norm gram into 6 Zones forming the basis of a new functional classification of the degree of severity of fecal incontinence as:


  • Grade I: Continent , anal staining due to minor anal problem(e.g. Hemorrhoids), and incontinence on top of normal anal Sphincter (e.g. fecal impaction).
  • Grade II: Gas incontinence.
  • Grade III: Fluid Soiling.
  • Grade IV: Solid Soiling.
  • Grade V: Fluid Incontinence.
  • Grade VI: Solid incontinence.


  • Each grade from II - VI is assigned with Letters P, S or U (as an indication for passive, stress or urgency anal incontinence respectively) in order to signify which measurements are to be used in calculation of Flow Index or in the Norm grams.


Allocating each patient on the norm gram is done in the same way as in defecation Norm gram (vide supra).

  • Discrepancies between mathematical Anal incontinence despite absence of clinical incontinence is considered as sub-clinical sphincter weakness which may be unmasked later on. E.g. a patient with sub-clinical gas incontinence may be masked by minimal amount of bowel gas produced in his bowel. Similarly a patient with mathematical stress fluid incontinence my be apparently normal because he has to have watery diarrhea simultaneously with an attack of chest infection to start to have clinical incontinence.






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