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Diseases of the Colon & Rectum

, Volume 49, Issue 6, pp 841–851 | Cite as

Fecal Incontinence in Females Older Than Aged 40 Years: Who is at Risk?

  • Madhulika G. VarmaEmail author
  • Jeanette S. Brown
  • Jennifer M. Creasman
  • David H. Thom
  • Stephen K. Van Den Eeden
  • Mary S. Beattie
  • Leslee L. Subak
  • Reproductive Risks for Incontinence Study at Kaiser (RRISK) Research Group
Article

Purpose

This study was designed to estimate the prevalence of, and identify risk factors associated with, fecal incontinence in racially diverse females older than aged 40 years.

Methods

The Reproductive Risks for Incontinence Study at Kaiser is a population-based study of 2,109 randomly selected middle-aged and older females (average age, 56 years). Fecal incontinence, determined by self-report, was categorized by frequency. Females reported the level of bother of fecal incontinence and their general quality of life. Potential risk factors were assessed by self-report, interview, physical examination, and record review. Multivariate logistic regression analysis was used to determine the independent association between selected risk factors and the primary outcome of any reported fecal incontinence in the past year.

Results

Fecal incontinence in the past year was reported by 24 percent of females (3.4 percent monthly, 1.9 percent weekly, and 0.2 percent daily). Greater frequency of fecal incontinence was associated with decreased quality of life (Medical Outcome Short Form-36 Mental Component Scale score, P = 0.01), and increased bother (P < 0.001) with 45 percent of females with fecal incontinence in the past year and 100 percent of females with daily fecal incontinence reporting moderate or great bother. In multivariate analysis, the prevalence of fecal incontinence in the past year increased significantly [odds ratio per 5 kg/m2 (95 percent confidence interval)] with obesity [1.2 (1.1–1.3)], chronic obstructive pulmonary disease [1.9 (1.3–2.9)], irritable bowel syndrome [2.4 (1.7–3.4)], urinary incontinence [2.1 (1.7–2.6)], and colectomy [1.9 (1.1–3.1)]. Latina females were less likely to report fecal incontinence than white females [0.6 (0.4–0.9)].

Conclusions

Fecal incontinence, a common problem for females, is associated with substantial adverse affects on quality of life. Several of the identified risk factors are preventable or modifiable, and may direct future research in fecal incontinence therapy.

Key words

Fecal incontinence Epidemiology Risk factors Prevalence 

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Copyright information

© The American Society of Colon and Rectal Surgeons 2006

Authors and Affiliations

  • Madhulika G. Varma
    • 1
    • 7
    Email author
  • Jeanette S. Brown
    • 2
    • 3
  • Jennifer M. Creasman
    • 3
  • David H. Thom
    • 4
  • Stephen K. Van Den Eeden
    • 5
  • Mary S. Beattie
    • 6
  • Leslee L. Subak
    • 2
    • 3
  • Reproductive Risks for Incontinence Study at Kaiser (RRISK) Research Group
  1. 1.Department of SurgeryUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA
  4. 4.Department of Family and Community MedicineUniversity of California, San FranciscoSan FranciscoUSA
  5. 5.Kaiser Permanente Division of ResearchOaklandUSA
  6. 6.Department of Medicine, Division of General Internal MedicineUniversity of California, San FranciscoSan FranciscoUSA
  7. 7.Department of SurgeryUniversity of California, San FranciscoSan FranciscoUSA

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