ABSTRACT
St. Mark’s Incontinence Score (GRADE C) This five question scale provides a score for the assessment of the severity of fecal incontinence (20) . It comprises five questions concerned with fecal leakage, bowel urgency, use of pads, medication, and interference with activities. The validation process entailed comparing the performance of this novel tool with Wexner, Pescatori (21) and a commercial, unvalidated scale (the American Medical Systems score) in small groups of patients. There was good inter-instrument correlation and also a good relationship with a diary card and objective “ clinical impression.” In addition, a smaller cohort of patients completed the score after surgical treatment, and it was found to be a treatment-responsive score. A more recent study of 390 patients with fecal incontinence compared subjective visual analog scale scores to the St. Marks score and showed only moderate correlation regardless of type of incontinence, age, or gender (22) . One-third of these patients also underwent biofeedback and only 65% of patients reported subjective changes reflected in the St. Marks score (22) .
