Skip to main content
SpringerLink
Log in

The prevalence and determinants of health care-seeking behavior for fecal incontinence in multiparous United Arab Emirates females

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: This study was designed to determine the prevalence and sociodemographics of fecal incontinence in United Arab Emirates females. METHODS: A representative sample of multiparous United Arab Emirates females aged 20 years or older (N=450) were randomly selected from the community (n=225) and health care centers (n=225). Patients were interviewed about inappropriate stool loss in the past year using a structured and pretested questionnaire. RESULTS: Fifty-one participants (11.3 percent) admitted fecal incontinence; 26 (5.8 percent) were incontinent to liquid stool and 25 (5.5 percent) to solid stool. Thirty-eight patients (8.4 percent) had double (urinary and fecal) incontinence. Sixty-five patients (14.4 percent) were incontinent to flatus only but not to stools. The association between having fecal incontinence and chronic constipation was significant (P<0.0001), but there was no significant association with other known risk factors such as age, parity, and previous instrumental delivery, episiotomy, perineal tears, or anorectal operations. Only 21 incontinent patients (41 percent) had sought medical advice. Patients did not seek medical advice because they were embarrassed to consult their physician (64.7 percent), they preferred to discuss the difficulty with friends, assuming that fecal incontinence would resolve spontaneously (47.1 percent) or was normal (31.3 percent), and they chose self-treatment as a result of low expectations for medical care (23.5 percent). Sufferers were bothered by the inability to pray (92.2 percent) and to have sexual intercourse (43.1 percent). Perceived causes of fecal incontinence were paralysis (90.2 percent), old age (80.4 percent), childbirth (23.5 percent), or menopause (19.6 percent). CONCLUSIONS: Fecal incontinence is common yet underreported by multiparous United Arab Emirates females because of cultural attitudes and inadequate public knowledge.

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. Sangwan YP, Coller JA. Fecal incontinence. Surg Clin North Am 1994;74:1377–98.

    PubMed  Google Scholar 

  2. Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum 1993;36:77–97.

    PubMed  Google Scholar 

  3. Jackson SL, Weber AM, Hull TL, Mitchinson AR, Walters MD. Fecal incontinence in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 1997;89:423–7.

    PubMed  Google Scholar 

  4. Shelton A, Madoff R. Defining anal incontinence: establishing a uniform continence scale. Semin Colon Rectal Surg 1997;8:54–60.

    Google Scholar 

  5. Thomas TM, Egan M, Walgrove A, Meade TW. The prevalence of faecal and double incontinence. Community Med 1984;6:216–20.

    PubMed  Google Scholar 

  6. Norton C. Faecal incontinence in adults. 1: Prevalence and causes. Br J Nurs 1996;5:1366–74.

    PubMed  Google Scholar 

  7. Madoff RD, Williams JG, Caushaj PF. Fecal incontinence. N Engl J Med 1992;326:1002–7.

    PubMed  Google Scholar 

  8. Rockwood TH, Church JM, Fleshman JW,et al. Fecal incontinence quality of life scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 2000;43:9–17.

    PubMed  Google Scholar 

  9. Reilly WT, Talley NJ, Pemberton JH, Zinsmeister AR. Validation of a questionnaire to assess fecal incontinence and associated risk factors: fecal incontinence questionnaire. Dis Colon Rectum 2000;43:146–54.

    PubMed  Google Scholar 

  10. Johanson JF, Lafferty J. Epidemiology of fecal incontinence: the silent affliction. Am J Gastroentrol 1996;91:33–6.

    Google Scholar 

  11. Giebel GD, Lefering R, Troidl H, Blochl H. Prevalence of faecal incontinence: what can be expected? Int J Colorectal Dis 1998;13:73–7.

    PubMed  Google Scholar 

  12. Nelson R, Norton N, Cautley E, Furner S. Community-based prevalence of anal incontinence. JAMA 1995;274:559–61.

    PubMed  Google Scholar 

  13. Gordon D, Groutz A, Goldman G,et al. Anal incontinence: prevalence among female patients attending a urogynecologic clinic. Neurourol Urodyn 1999;18:199–204.

    PubMed  Google Scholar 

  14. MacArthur C, Bick DE, Keighley MR. Faecal incontinence after childbirth. Br J Obstet Gynaecol 1997;104:46–50.

    PubMed  Google Scholar 

  15. Mallett VT, Bump RC. The epidemiology of pelvic floor dysfunction. Curr Opin Obstet Gynecol 1994;6:308–12.

    PubMed  Google Scholar 

  16. Rizk DE, Shaheen H, Thomas L, Dunn E, Hassan MY. The prevalence and determinants of health-care seeking behavior for urinary incontinence in United Arab Emirates women. Int Urogynecol J Pelvic Floor Dysfunct 1999;10:160–5.

    PubMed  Google Scholar 

  17. Annual Health Report 1998. Preventive Medicine Department, Ministry of Health, United Arab Emirates, 1998.

  18. Cochran WG. Sampling techniques. 3rd ed. New York: John Wiley and Sons, 1977:72–88.

    Google Scholar 

  19. Osterberg A, Graf W, Karlbom U, Pahlman L. Evaluation of a questionnaire in the assessment of patients with faecal incontinence and constipation. Scand J Gastroentrol 1996;31:575–80.

    Google Scholar 

  20. Leroi A, Weber J, Menard J, Touchais J, Denis P. Prevalence of anal incontinence in 409 patients investigated for stress urinary incontinence. Neurourol Urodyn 1999;18:579–90.

    PubMed  Google Scholar 

  21. Roberts RO, Jacobsen SJ, Reilly WT, Pemberton JH, Lieber MM, Talley NJ. Prevalence of combined fecal and urinary incontinence: a community-based study. J Am Geriatr Soc 1999;47:837–41.

    PubMed  Google Scholar 

  22. Chassagne P, Landrin I, Neveu C,et al. Fecal incontinence in the institutionalized elderly: incidence, risk factors and prognosis. Am J Med 1999;106:185–90.

    PubMed  Google Scholar 

  23. Enck P, Bielefedt K, Rathmann W, Purrmann J, Tschope D, Erckenbrecht JF. Epidemiology of faecal incontinence in selected patient groups. Int J Colorectal Dis 1991;6:143–6.

    PubMed  Google Scholar 

  24. Zetterstrom JP, Lopez A, Anzen B, Dolk A, Norman M, Mellegren A. Anal incontinence after vaginal delivery: a prospective study in primiparous women. Br J Obstet Gynaecol 1999;106:324–30.

    PubMed  Google Scholar 

  25. Khullar V, Damiano R, Toozs-Hobson P, Cardozo L. Prevalence of faecal incontinence among women with urinary incontinence. Br J Obstet Gynaecol 1998;105:1211–3.

    PubMed  Google Scholar 

  26. Rockwood TH, Church JM, Fleshman JW,et al. Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 1999;42:1525–32.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. From the Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, United Arab Emirates Universit, Al-Ain, United Arab Emirates

    Diaa E. E. Rizk M.D.

  2. Department of Pharmacology, Faculty of Medicine and Health Sciences, United Arab Emirates Universit, Al-Ain, United Arab Emirates

    Mohammed Y. Hassan Ph.D.

  3. Department of Biology, Faculty of Science, United Arab Emirates University, Al-Ain, United Arab Emirates

    Huda Shaheen M.Sc.

  4. Department of Family Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates

    John V. Cherian B.Sc. & Earl Dunn M.D.

  5. Department of Primary Health Care, Tawam Hospital, Al-Ain, United Arab Emirates

    Rosetta Micallef M.D.

Authors
  1. Diaa E. E. Rizk M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammed Y. Hassan Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Huda Shaheen M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John V. Cherian B.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rosetta Micallef M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Earl Dunn M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Rizk, D.E.E., Hassan, M.Y., Shaheen, H. et al. The prevalence and determinants of health care-seeking behavior for fecal incontinence in multiparous United Arab Emirates females. Dis Colon Rectum 44, 1850–1856 (2001). https://doi.org/10.1007/BF02234467

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02234467

Key words

Search

Navigation