What is the St Mark's incontinence score?

It is a seven-question score for bowel incontinence published in 1999, also called the Vaizey score after its first author. It rates leakage of solid stool, liquid stool and gas, lifestyle impact, pad use, firming medicines and urgency, for a total from 0 to 24.

What is a normal St Mark's score?

A score of 0 means full continence. The scale has no published mild, moderate or severe bands, so any score above 0 simply means some incontinence, with higher numbers meaning more severe.

What change in the St Mark's score is meaningful?

A fall of about 5 points is the change best linked with people feeling better. Estimates across studies range from 3 to 5 points, so they are best used as a guide.

What is the difference between the St Mark's and Wexner incontinence scores?

The St Mark's score is built on the Wexner (Cleveland Clinic) score but adds urgency and the use of stool-firming medicines, and gives pad use less weight. It runs from 0 to 24, while the Wexner incontinence score runs from 0 to 20.

Does leaking gas count as bowel incontinence?

Yes. Being unable to hold in wind is one of the four frequency items on the St Mark's score and can add up to 4 points.

How common is bowel incontinence?

NICE estimates that between 1% and 10% of adults are affected, depending on how it is defined. It is more common in people with loose stools or diarrhoea, and many people never tell anyone, including their doctor.

Can pelvic floor physiotherapy help bowel incontinence?

NICE lists pelvic floor muscle training and biofeedback among the specialised treatments to consider when leakage continues after first steps such as getting stool consistency right. A doctor can refer you to a continence or pelvic floor physiotherapy service.

Your answers are used to calculate the result and email it to you. The tool does not create an account or save your answers to a medical record.

St Mark's Bowel Incontinence Score Calculator

Score bowel leakage and urgency privately, the way continence clinics do.

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Updated October 3, 2026

The short answer

The St Mark's (Vaizey) incontinence score rates bowel leakage over the past four weeks. Leakage of solid stool, liquid stool and gas, and changes to your lifestyle, each score 0 (never) to 4 (daily). Needing a pad or plug adds 2, taking constipating medicine adds 2 and being unable to hold on for 15 minutes adds 4. The total runs from 0, full continence, to 24. There are no official severity bands; a fall of about 5 points is the change linked with people feeling better.

In the past four weeks, how often have you leaked solid stool?Any amount counts, including small marks on underwear.

In the past four weeks, how often have you leaked liquid stool?

In the past four weeks, how often have you been unable to hold in wind (gas)?

In the past four weeks, how often has bowel control changed what you do?For example staying home, planning routes around toilets, or avoiding meals before going out.

Do you need to wear a pad or an anal plug because of bowel leakage?

Do you take medicines that firm up or slow down your stools?For example loperamide. The scale counts it whether or not it is prescribed and whether or not it helps.

Are you unable to hold on for 15 minutes once you feel the urge to go?

Your previous St Mark's score, if you know itOptional. Used to show how much your score has changed.

How to use the Bowel Incontinence Score Calculator

1Think back over the past four weeks and choose how often you leaked solid stool, liquid stool and gas.
2Choose how often bowel control changed your plans, then answer the three yes or no questions about pads, firming medicines and holding on for 15 minutes.
3Add your previous score if you have one.
4Get your total out of 24, the item that contributes most and, with a previous score, whether the change is large enough to be meaningful.

How the St Mark's score is worked out

Vaizey, Kamm and colleagues in London published the score in 1999. It is usually called the St Mark's score, or the Vaizey score after its first author. They built it on the older Cleveland Clinic (Wexner) incontinence score and added two things that score missed: urgency, meaning being unable to hold on for 15 minutes, and the use of medicines that firm the stool. They also gave pad use less weight, because some people wear a pad out of worry rather than because they leak often.

In the original study of 23 patients, the new scale matched two specialists' clinical judgement more closely than three older scales, and it changed the most after surgery. That is why it became one of the most used incontinence measures in research.

Item	How it is scored	Points
Leakage of solid stool	Never 0, rarely 1, sometimes 2, weekly 3, daily 4	0 to 4
Leakage of liquid stool	Never 0, rarely 1, sometimes 2, weekly 3, daily 4	0 to 4
Leakage of gas	Never 0, rarely 1, sometimes 2, weekly 3, daily 4	0 to 4
Alteration in lifestyle	Never 0, rarely 1, sometimes 2, weekly 3, daily 4	0 to 4
Need to wear a pad or plug	No 0, yes 2	0 or 2
Taking constipating medicines	No 0, yes 2	0 or 2
Unable to defer defecation for 15 minutes	No 0, yes 4	0 or 4

What the frequency words mean

The four frequency items all look back over the past four weeks. These definitions come from the scale as it is reproduced in published guidelines. They are not the same as the older Wexner incontinence score, which counts rarely as less than once a month.

Answer	Meaning over the past four weeks	Points
Never	No episodes	0
Rarely	1 episode	1
Sometimes	More than 1 episode, but less than once a week	2
Weekly	Once a week or more, but less than once a day	3
Daily	Once a day or more	4

What your score means

A score of 0 means full continence and 24 the most severe incontinence. The original paper did not publish mild, moderate or severe cut-offs, and we have not found validated ones, so this calculator does not give your score a severity label.

What is better studied is change. In a Dutch study of 194 people having pelvic floor rehabilitation, a fall of 5 points was the threshold that best matched people saying they felt better. A later analysis from a randomised trial put the minimal important change between 3 and 5 points and advised using those figures as a guide rather than a hard rule.

Urgency carries the most weight of any single answer. If being unable to hold on is the main problem, our guides to stopping urgency with ulcerative colitis and needing to go right after eating explain where it comes from.

Result	What the evidence supports saying
0	Full continence
1 to 24	Some incontinence; higher means more severe (no validated bands)
A fall of about 5 points	The change most linked with people feeling better
A fall of 3 to 4 points	Possibly meaningful; estimates range from 3 to 5

What helps, according to guidelines

The NICE guideline on faecal incontinence in adults starts with the basics: finding what is driving the leakage, aiming for a stool consistency that is easier to control, regular unhurried toilet routines, reviewing medicines that loosen stools, and practical support such as pads, skin care and toilet access cards.

For people who still have leakage after that, NICE describes specialised management that may include pelvic floor muscle training, bowel retraining, biofeedback and dietary assessment, usually through a specialist continence or pelvic floor physiotherapy service. It also lists people with loose stools or diarrhoea from any cause among the groups clinicians should ask about leakage, because so many people never mention it.

If urgency is affecting your job, our guide to asking for IBS accommodations at work covers what to ask for and how.

Frequently asked questions

What is the St Mark's incontinence score?: It is a seven-question score for bowel incontinence published in 1999, also called the Vaizey score after its first author. It rates leakage of solid stool, liquid stool and gas, lifestyle impact, pad use, firming medicines and urgency, for a total from 0 to 24.
What is a normal St Mark's score?: A score of 0 means full continence. The scale has no published mild, moderate or severe bands, so any score above 0 simply means some incontinence, with higher numbers meaning more severe.
What change in the St Mark's score is meaningful?: A fall of about 5 points is the change best linked with people feeling better. Estimates across studies range from 3 to 5 points, so they are best used as a guide.
What is the difference between the St Mark's and Wexner incontinence scores?: The St Mark's score is built on the Wexner (Cleveland Clinic) score but adds urgency and the use of stool-firming medicines, and gives pad use less weight. It runs from 0 to 24, while the Wexner incontinence score runs from 0 to 20.
Does leaking gas count as bowel incontinence?: Yes. Being unable to hold in wind is one of the four frequency items on the St Mark's score and can add up to 4 points.
How common is bowel incontinence?: NICE estimates that between 1% and 10% of adults are affected, depending on how it is defined. It is more common in people with loose stools or diarrhoea, and many people never tell anyone, including their doctor.
Can pelvic floor physiotherapy help bowel incontinence?: NICE lists pelvic floor muscle training and biofeedback among the specialised treatments to consider when leakage continues after first steps such as getting stool consistency right. A doctor can refer you to a continence or pelvic floor physiotherapy service.
Is my result stored?: Your answers are used to calculate the result and email it to you. The tool does not create an account or save your answers to a medical record.

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Sources

Vaizey CJ, Carapeti E, Cahill JA, Kamm MA. Prospective comparison of faecal incontinence grading systems. Gut. 1999;44(1):77-80. doi:10.1136/gut.44.1.77
Maeda K, Yamana T, Takao Y, Mimura T, Katsuno H, Seki M, et al. Japanese practice guidelines for fecal incontinence part 1: definition, epidemiology, etiology, pathophysiology and causes, risk factors, clinical evaluations, and symptomatic scores and QoL questionnaire for clinical evaluations (English version). J Anus Rectum Colon. 2021;5(1):52-66. doi:10.23922/jarc.2020-057
Nevler A. The epidemiology of anal incontinence and symptom severity scoring. Gastroenterol Rep (Oxf). 2014;2(2):79-84. doi:10.1093/gastro/gou005
Bols EM, Hendriks HJ, Deutekom M, Berghmans LC, Baeten CG, de Bie RA. Inconclusive psychometric properties of the Vaizey score in fecally incontinent patients: a prospective cohort study. Neurourol Urodyn. 2010;29(3):370-7. doi:10.1002/nau.20758
Bols EM, Hendriks HJ, Berghmans LC, Baeten CG, de Bie RA. Responsiveness and interpretability of incontinence severity scores and FIQL in patients with fecal incontinence: a secondary analysis from a randomized controlled trial. Int Urogynecol J. 2013;24(3):469-78. doi:10.1007/s00192-012-1886-9
National Institute for Health and Care Excellence. Faecal incontinence in adults: management. Clinical guideline CG49. London: NICE; 2007. https://www.nice.org.uk/guidance/cg49

Cite this tool

Clairop. Bowel Incontinence Score Calculator. www.clairop.com/tools/bowel-incontinence-score. Updated October 3, 2026.

Clairop is a general wellness app for people living with a diagnosed digestive condition. It does not replace professional medical care, diagnosis, or treatment. Always follow your healthcare provider's advice.

Clairop logs meals, symptoms and stool in seconds, then looks for the foods your gut reacts to, including reactions that land days later.

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