People with faecal incontinence (FI) suffer from chronic involuntary loss of bowel content. Patients often experience embarrassment, shame, low self-esteem, and depression, affecting their quality of life. Treatment approaches vary, and less invasive options should be tried before considering more invasive treatments. It's important to consider contributing factors, physician and patient preferences, and available procedures. This article discusses common mistakes in treating faecal incontinence and how to avoid them, based on evidence and clinical experience.

Familial Mediterranean fever (FMF), also called periodic disease, Armenian disease, etc., is a prototypical autoinflammatory disorder where the underlying mechanism is the dysfunction of innate immunity, resulting in unprovoked episodes of inflammation.¹ Although considered rare worldwide, it is prevalent in people of Mediterranean origin; however, one can expect to encounter patients in all parts of the modern world. FMF is a monogenic disease with autosomal recessive inheritance.² Unlike other monogenic disorders, the diagnosis remains largely clinical, and it is important to understand the limitations of genetic testing. Another distinguishing feature is the well-established effectiveness of lifelong monotherapy with colchicine in preventing attacks and complications.³

Short bowel is a condition that occurs after single or multiple intestinal resections. The incidence of short bowel in Europe is 2 per million of the population and it carries with it lifelong morbidity and mortality. The initial recognition and management of short bowel in the adult population tends to occur in the postoperative period and in the secondary care setting, where specialist input from clinicians experienced in short bowel is often lacking.

Carbohydrates not absorbed in the small intestine are fermented by colonic bacteria to organic acids and gases(e.g. carbon dioxide, hydrogen and methane), part of which is absorbed in the colon, the other part remaining in the lumen. Large interindividual differences have been demonstrated for the production of such acids and gas. Carbohydrate malabsorption can be diagnosed by using the hydrogen breath test, because the gases produced after administration of a provocative dose of carbohydrate are unique products of bacterial carbohydrate fermentation.