Gastroenterology

Gastroenterology

Volume 129, Issue 1, July 2005, Pages 42-49
Gastroenterology

Clinical-alimentary tract
Prevalence and Burden of Fecal Incontinence: A Population-Based Study in Women

https://doi.org/10.1053/j.gastro.2005.04.006Get rights and content

Background & Aims: The epidemiology of fecal incontinence (FI) is incompletely understood. We report the prevalence, clinical spectrum, health care-seeking behavior, and quality of life (QOL) in community women with FI. Methods: A questionnaire was mailed to an age-stratified random sample of 5300 Olmsted County, Minnesota, women identified by the Rochester Epidemiology Project. Symptom severity was assessed by a validated scale, and impact on QOL was evaluated for subjects who had any FI during the past year. The prevalence of FI was calculated with direct age adjustment to the 2000 US white female population. Results: Altogether, 2800 of 5300 women (53%) responded to the survey. The overall age-adjusted prevalence of FI in the past year was 12.1 per 100 (95% confidence interval, 11.0–13.1). The prevalence increased with age from 7 (third decade) to 22 (sixth decade) per 100 and was steady thereafter. Symptoms were mild (45%), moderate (50%), or severe (5%), and symptom severity was related to the impact of FI on QOL and physician-consulting behavior. Moderate to severe impact on ≥1 domain of QOL was reported by 6% with mild, 35% with moderate, and 82% with severe symptoms, whereas 5% with mild, 10% with moderate, and 48% with severe FI had consulted a physician for FI in the past year. Conclusions: More than 1 of 10 adult women in the population have FI; almost 1 of 15 have moderate to severe FI. FI significantly impacts QOL and prompts health care utilization predominantly in women with moderate to severe symptoms.

Section snippets

Subjects and Methods

The Olmsted County, Minnesota, population comprises approximately 100,000 persons, of whom 96% are white; sociodemographically, the community is similar to the US white population.13 In Olmsted County, 80% of the population resides within 5 miles of Rochester, and residents receive their medical care almost exclusively from 2 group practices: Mayo Medical Center and Olmsted Medical Center. Annually, more than 80% of the entire population is attended by one or both of these 2 practices, and

Prevalence and Duration of FI

The age-adjusted prevalence of any history of FI was 14 per 100 (95% CI, 12.8–15.1). The age-adjusted prevalence of FI in the past year was 12.1 per 100 (95% CI, 11.0–13.1). The age-specific prevalence in the past year increased (P < .0001) with age until the sixth decade (Figure 1).

Among the 507 women with FI, the symptom began before the age of 40 years in 31%, between 41 and 60 years in 37%, and between 61 and 80 years in 32%. Consequently, the estimated median duration of FI was 5 years

Discussion

There is increasing awareness that FI is a relatively common symptom, particularly among the elderly and nursing home residents. Previous estimates of the prevalence of FI in the population have ranged from 2.2% to 15%.7 In the present study, the age-adjusted prevalence of FI in women was 12.1%, which is higher than in 2 earlier studies in a general population in this country5, 8 but comparable to the prevalence of FI in more recent studies, for example, from Australia,9, 10 the United Kingdom,

References (32)

  • S.J. Jacobsen et al.

    Participation bias in a population-based echocardiography study

    Ann Epidemiol

    (2004)
  • W.E. Whitehead et al.

    Advancing the treatment of fecal and urinary incontinence through research

    Gastroenterology

    (2004)
  • R. Nelson et al.

    Fecal incontinence in Wisconsin nursing homesprevalence and associations

    Dis Colon Rectum

    (1998)
  • D.A. Drossman et al.

    U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact

    Dig Dis Sci

    (1993)
  • R. Nelson et al.

    Community-based prevalence of anal incontinence

    JAMA

    (1995)
  • T.C.F. Lam et al.

    Prevalence of faecal incontinenceobstetric and constipation-related risk factors; a population-based study

    Colorectal Dis

    (1999)

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    Supported in part by grants R01 HD38666, R01 HD41129, and R01 AR30582 and General Clinical Research Center grant M01 RR00585 from the National Institutes of Health, US Public Health Service.

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    Copyright © 2005 American Gastroenterological Association. Published by Elsevier Inc. All rights reserved.