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

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Diseases of the Colon & Rectum

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.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of California, San Francisco, San Francisco, California, USA

    Madhulika G. Varma M.D.

  2. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA

    Jeanette S. Brown M.D. & Leslee L. Subak M.D.

  3. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA

    Jeanette S. Brown M.D., Jennifer M. Creasman M.S.P.H. & Leslee L. Subak M.D.

  4. Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA

    David H. Thom M.D., Ph.D.

  5. Kaiser Permanente Division of Research, Oakland, California, USA

    Stephen K. Van Den Eeden Ph.D.

  6. Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, California, USA

    Mary S. Beattie M.D.

  7. Department of Surgery, University of California, San Francisco, 2330 Post Street, Suite 260, San Francisco, California, 94115, USA

    Madhulika G. Varma M.D.

Authors
  1. Madhulika G. Varma M.D.
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  2. Jeanette S. Brown M.D.
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  7. Leslee L. Subak M.D.
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Consortia

Reproductive Risks for Incontinence Study at Kaiser (RRISK) Research Group

Corresponding author

Correspondence to Madhulika G. Varma M.D..

Additional information

The Reproductive Risk of Incontinence Study in Kaiser (RRISK) was funded by the National Institutes of Diabetes and Digestive and Kidney Diseases Grant # R01-DK53335.

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Varma, M.G., Brown, J.S., Creasman, J.M. et al. Fecal Incontinence in Females Older Than Aged 40 Years: Who is at Risk?. Dis Colon Rectum 49, 841–851 (2006). https://doi.org/10.1007/s10350-006-0535-0

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  • DOI: https://doi.org/10.1007/s10350-006-0535-0

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