The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on injectable bulking agents for faecal incontinence.


Faecal incontinence is when a person loses the ability to control their bowel movements. The procedure involves injecting a material into the muscles around the anus (anal sphincter) with the aim of bulking the sides of the sphincter. Different materials are available to provide the extra strength, and these are called bulking agents.

Coding recommendations

H57.8 Other specified other operations on the anal sphincter to control continence

Y39.3 Injection of inert substance into organ NOC

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.