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Postpartum fecal incontinence is more common in women with irritable bowel syndrome

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Diseases of the Colon & Rectum

Abstract

PURPOSE: Anal sphincter damage can occur during vaginal delivery and may lead to impairment of fecal continence. The aim of this study was to determine the influence of irritable bowel syndrome on symptoms of fecal incontinence following first vaginal delivery. METHODS: A prospective, observational study was performed before delivery, six weeks, and six months following delivery in primiparous women. A bowel function questionnaire was completed, and anal vector manometry, mucosal electrosensitivity, pudendal nerve terminal motor latency, and anal endosonography were performed. A total of 208 women were assessed before and after delivery, and 104 primigravid women were studied after delivery only. A total of 34 of 312 (11 percent) had an existing diagnosis of irritable bowel syndrome. RESULTS: The prevalence of abnormal manometry or endosonography was similar in women with and without irritable bowel syndrome. However, six weeks after delivery, women with irritable bowel syndrome had a higher incidence of defecatory urgency (64 percent) and loss of control of flatus (35 percent) compared with those without (urgency, 10 percent,P<0.001; flatus, 13 percent,P=0.007). The incidence of frank fecal incontinence was similar in the two groups. Women with IBS had increased mucosal sensitivity to electrical stimulation of the upper anal canal both before and after delivery. CONCLUSION: Women with IBS are more likely to experience subjective alteration of fecal continence postpartum compared with the healthy primigravid population, but they are not at increased risk of anal sphincter injury.

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Authors and Affiliations

  1. From the Departments of Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, UK

    Valerie S. Donnelly M.D. (M.R.C.O.G.) & Colm O'Herlihy M.D. (F.R.C.O.G.)

  2. the Department of Radiology, Mater Misericordiae Hospital, Dublin, Ireland

    Deirdre M. Campbell M.B., B.Ch. (F.R.C.R.)

  3. Department of Surgery, Mater Misericordiae Hospital, Eccles Street, Dublin 2, Ireland

    P. Ronan O'Connell M.D. (F.R.C.S.I.)

Authors
  1. Valerie S. Donnelly M.D.
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  2. Colm O'Herlihy M.D.
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  3. Deirdre M. Campbell M.B., B.Ch.
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  4. P. Ronan O'Connell M.D.
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Additional information

Funded by the research colleges of the National Maternity and Mater Misericordiae Hospitals, Dublin, Ireland.

Read, in part, at the meeting of the Irish Society of Gastroenterology, June 3 to 4, 1994, and poster presentation at the meeting of the European Council for Coloproctology, Barcelona, Spain, June 15 to 17, 1995. Published in abstract form in Ir J Med Sci 1994;163:6.

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Donnelly, V.S., O'Herlihy, C., Campbell, D.M. et al. Postpartum fecal incontinence is more common in women with irritable bowel syndrome. Dis Colon Rectum 41, 586–589 (1998). https://doi.org/10.1007/BF02235263

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  • DOI: https://doi.org/10.1007/BF02235263

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