Skip to main content

Advertisement

SpringerLink
Log in

Clinician Administered and Self-Report Survey Both Effective for Identifying Fecal Incontinence in Patients with Inflammatory Bowel Disease

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Objectives

To test two methods for reporting of fecal incontinence (FI) in people with inflammatory bowel disease.

Methods

Consecutive patients from IBD clinics in six UK hospitals completed a short three-item case-finding survey about FI; they either completed the survey themselves or were asked the same questions face to face by a clinician.

Results

Of 1336 eligible patients with complete data (48% male; mean 43 years; 55% Crohn’s disease, 41% ulcerative colitis), 772 were asked about FI face to face, and 564 self-completed the survey: FI was reported in 63% and 56%, respectively (p = 0.012). In regression analyses, those aged 51–60, having Crohn’s disease and higher disease activity, were more likely to report FI. Of all respondents, 38.7% were interested in receiving help for their incontinence.

Conclusions

Fecal incontinence affects the majority of people with IBD. Although more patients reported fecal incontinence when asked face to face than self-reported, routine screening by either method in clinical practice is recommended. Over one-third of patients with IBD want help for bowel control problems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gu P, Kuenzig ME, Kaplan GG, Pimentel M, Rezaie A. Fecal incontinence in inflammatory bowel disease: a systematic review and meta-analysis. Inflamm Bowel Dis. 2018;24:1280–1290.

    Article  Google Scholar 

  2. Macmillan AK, Merrie AEH, Marshall RJ, Parry BR. The prevalence of fecal incontinence in community-dwelling adults: a systematic review of the literature. Dis Colon Rectum. 2004;47:1341–1349.

    Article  Google Scholar 

  3. Whitehead WE, Borrud L, Goode PS, et al. Fecal incontinence in US adults: epidemiology and risk factors. Gastroenterology. 2009;137:e2.

    Article  Google Scholar 

  4. Norton C, Dibley LB, Bassett P. Faecal incontinence in inflammatory bowel disease: associations and effect on quality of life. J Crohns Colitis. 2013;7:e302–e311.

    Article  Google Scholar 

  5. Subasinghe D, Navarathna N, Samarasekera DN. Faecal incontinence and health related quality of life in inflammatory bowel disease patients: findings from a tertiary care center in South Asia. World J Gastroenterol. 2016;7:447–452.

    Google Scholar 

  6. Lönnfors S, Vermeire S, Greco M, Hommes D, Bell C, Avedano L. IBD and health-related quality of life: discovering the true impact. J Crohns Colitis. 2014;8:1281–1286.

    Article  Google Scholar 

  7. Pihl Lesnovska K, Hollman Frisman G, Hjortswang H, Börjeson S. Critical situations in daily life as experienced by patients with inflammatory bowel disease. Gastroenterol Nurs. 2016;39:195–203.

    Article  Google Scholar 

  8. Dibley L, Norton C. Experiences of fecal incontinence in people with inflammatory bowel disease: self-reported experiences among a community sample. Inflamm Bowel Dis. 2013;19:1450–1462.

    Article  Google Scholar 

  9. Jelsness-Jorgensen L-P, Moum M, Bernklev T. Worries and concerns among inflammatory bowel disease patients followed prospectively over one year. Gastroenterol Res Pract. 2011;10:492034.

    Google Scholar 

  10. Casati J, Toner B, de Rooy E, Drossman D, Maunder R. Concerns of patients with inflammatory bowel disease: a review of emerging themes. Dig Dis Sci. 2000;45:26–31. https://doi.org/10.1023/A:1005492806777.

    Article  CAS  PubMed  Google Scholar 

  11. Farrell D, McCarthy G, Savage E. Gu P, Kuenzig ME, Kaplan GG, Pimentel M, Rezaie A. Self-reported symptom burden in individuals with inflammatory bowel disease. J Crohns Colitis. 2016;10:315–322.

    Article  Google Scholar 

  12. Hart AL, Lomer M, Verjee A, et al. What are the top 10 research questions in the treatment of inflammatory bowel disease? A priority setting partnership with the James Lind Alliance. J Crohns Colitis. 2017;11:204–211.

    Article  Google Scholar 

  13. NICE. Management of Faecal Incontinence in Adults. London: National Institute for Health and Clinical Excellence; 2007. https://www.nice.org.uk/guidance/cg49. Accessed 27.30.2020.

  14. Duncan J, Sebepos-Rogers G, Poole-Wilson O, et al. Faecal incontinence in inflammatory bowel disease: we don’t ask and they don’t tell. J Crohns Colitis. 2013;7:S106–S107.

    Article  Google Scholar 

  15. Buckley B. It’s the way you ask that matters: comparison of data relating to prevalence of incontinence aid use from two surveys of people with multiple sclerosis. J Wound Ostomy Cont Nurs. 2006;33:26–29.

    Article  Google Scholar 

  16. Norton C, Dibley LB, Hart A, et al. Faecal incontinence intervention study (FINS): self-management booklet information with or without nurse support to improve continence in people with inflammatory bowel disease: study protocol for a randomized controlled trial. Trials. 2015;16:444.

    Article  Google Scholar 

  17. Harvey R, Bradshaw J. A simple index of Crohn’s disease activity. Lancet. 1980;8167:514.

    Article  Google Scholar 

  18. Walmsley R, Ayres R, Pounder R, Allen R. A simple clinical colitis activity index. Gut. 1998;43:29–32.

    Article  CAS  Google Scholar 

  19. Ng K-S, Sivakumaran Y, Nasser N, et al. Faecal incontinence: community prevalence and associated factors: a systematic review. Dis Colon Rectum. 2015;58:1194–1209.

    Article  Google Scholar 

  20. Stansfield C. Inflammatory bowel disease nurse specialists: sailing into a perfect storm? Br J Nurs. 2019;28:278–280.

    Article  Google Scholar 

  21. Drossman DA, Corazziarri E, Delvaux M, et al. ROME III: The Functional Gastrointestinal Disorders. 3rd ed. Yale University Section of Digestive Disease: Degnon Associates, 2006.

  22. Simren M, Palsson OS, Whitehead WE. Update on Rome IV criteria for colorectal disorders: implications for practice. Curr Gastroenterol Rep. 2017;19:15. https://doi.org/10.1007/s11894-017-0554-0.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Whitehead W, Simren M, Busby-Whitehead J, et al. Fecal incontinence diagnosed by the Rome IV criteria in the United States, Canada, and the United Kingdom. Clin Gastroenterol Hepatol. 2020;18:385–391.

    Article  Google Scholar 

Download references

Acknowledgments

The team acknowledges the assistance of Irene Simmons, the original project coordinator for this study.

Funding

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0613-31033). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Author information

Author notes

  1. Lesley Dibley

    Present address: Centre for Chronic Illness and Ageing, Institute for Lifecourse Development, School of Health Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich (Southwood Site), Rm G208, Grey Building, Avery Hill Road, Eltham, London, SE9 2 UG, UK

  2. Julie Duncan

    Present address: Takeda UK, London, UK

  3. Vichithranie W. Madurasinghe

    Present address: University of Oxford, Oxford, UK

Authors and Affiliations

  1. Florence Nightingale Faculty of Nursing, Midwifery and Palliative, King’s College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK

    Lesley Dibley, Tiffany Wade & Christine Norton

  2. St Mark’s Hospital (IBD Unit), Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK

    Ailsa Hart

  3. Department of Gastroenterology, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    Julie Duncan

  4. Blizard Institute, Barts and The London School of Medicine and Dentistry, The Blizard Building, 4 Newark Street, London, E1 2AT, UK

    Charles H. Knowles

  5. Pragmatic Clinical Trials Unit (PCTU), Centre for Primary Care and Public Health, Queen Mary University, London (Whitechapel Campus), Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK

    Sally Kerry, Doris Lanz & Vichithranie W. Madurasinghe

  6. Crohn’s and Colitis UK, 1 Bishops Square, Hatfield Business Park, Hatfield, AL10 9NE, UK

    Helen Terry

  7. Patient and Public Involvement Team Lead, London, UK

    Azmina Verjee

  8. School of Health Sciences, University of Southampton, Southampton, UK

    Mandy Fader

Authors
  1. Lesley Dibley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ailsa Hart
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julie Duncan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Charles H. Knowles
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sally Kerry
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Doris Lanz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vichithranie W. Madurasinghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tiffany Wade
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Helen Terry
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Azmina Verjee
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Mandy Fader
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Christine Norton
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Christine Norton (Chief Investigator) conceived the study. Christine Norton, Lesley Dibley, Julie Duncan, Ailsa Hart, Charles Knowles, Helen Terry, Azmina Verjee and Sally Kerry designed the study and developed the funding application. Lesley Dibley (Project Manager), was responsible for set up and oversight of participating sites, ethics applications, and qualitative analysis. Doris Lanz: was project coordinator at the Pragmatic Clinical Trials Unit. Sally Kerry had oversight of statistical analysis. Vichithranie Madurasinghe reviewed the statistical analysis plan and conducted the data analysis. Tiffany Wade conducted and analyzed qualitative interviews with patient participants, clinicians delivering the intervention, and with project staff. Azmina Verjee led the patient and Public Involvement team. Mandy Fader was Chair of the steering group, responsible for study review and monitoring. All authors contributed to manuscript writing and/or revising of drafts.

Corresponding author

Correspondence to Lesley Dibley.

Ethics declarations

Conflict of interest

Lesley Dibley has received speaker fees from Janssen, AbbVie, and Eli-Lilly, and consultancy fees from GL Assessments and Crohn’s & Colitis UK. Ailsa Hart has served as consultant, advisory board member or speaker for AbbVie, Atlantic, Bristol-Myers Squibb, Celltrion, Falk, Ferring, Janssen, MSD, Napp Pharmaceuticals, Pfizer, Pharmacosmos, Shire, and Takeda. She also serves on the Global Steering Committee for Genentech. Julie Duncan has received speaker fees from Warner Chilcott, Dr Falk pharma, Abbvie, Janssen, Takeda, MSD while an IBD Nurse Manager at Guy’s & St Thomas’s Hospitals Trust. She has been fully employed by Takeda UK Ltd since 2018. Charles Knowles has received speaker fees from, and acted as consultant for, Medtronic. Christine Norton has received speaker fees from Ferring, Takeda, and Tillotts Pharma. Mandy Fader, Sally Kerry, Doris Lanz, Vichithranie Madurasinghe, Tiffany Wade, Helen Terry, and Azmina Verjee have no conflicts of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dibley, L., Hart, A., Duncan, J. et al. Clinician Administered and Self-Report Survey Both Effective for Identifying Fecal Incontinence in Patients with Inflammatory Bowel Disease. Dig Dis Sci 66, 2024–2031 (2021). https://doi.org/10.1007/s10620-020-06418-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-020-06418-9

Keywords

Search

Navigation