RANCHO MIRAGE, CALIF. — The prevalence of fecal incontinence ranged from 3% of women in their 30s and 40s to nearly 15% of women in their 80s and 90s in the first large epidemiologic study of fecal incontinence among women living in a U.S. community.
Overall, more than 7% of the 3,536 women who returned mailed surveys reported fecal incontinence, defined as accidental loss of stool at least monthly. Of those with fecal incontinence, 47% said they used pads for sanitary protection, and 53% said the problem caused them to alter their lifestyle, Jennifer Melville, M.D., and her associates reported in a poster presentation at the annual meeting of the Society of Gynecologic Surgeons.
“Fecal incontinence is very prevalent and causes significant quality-of-life impacts,” said Dr. Melville of the University Washington, Seattle, during an oral presentation in which she discussed the findings at the meeting. Physicians can assist women by helping to manage the problem, she added.
The responses made up 64% of 6,000 surveys mailed to women aged 30–90 years who were enrolled in a nonprofit HMO in Washington state, GroupHealth Cooperative. The surveys asked specifically about fecal incontinence, not anal incontinence, which includes flatus. Of the women with fecal incontinence, 37% said they had daily or weekly episodes of incontinence. They were incontinent of liquid stool in 47% of cases, solid stool in 23% of cases, and both liquid and solid in 30% of cases.
An analysis of the HMO's automated data on the respondents showed that the women with fecal incontinence were twice as likely to have moderate medical illness and nearly three times as likely to have high-level comorbidity when compared with continent women.
Moreover, women with fecal incontinence were twice as likely to have urinary incontinence and three times as likely to have major depressive disorder as were continent women.
A history of operative vaginal delivery raised the risk for fecal incontinence 58%.
Women with fecal incontinence were more likely to report significant functional impairments, measured in the survey using the World Health Organization Disability Assessment Schedule II. The mean scores on this measure were 24 for women with fecal incontinence and 11 for continent women. The scores for incontinent women are comparable to scores for people with disabling medical conditions like chronic back pain or ankylosing spondylitis, Dr. Melville said.