Prevalence of fecal incontinence and its relationship with urinary incontinence in women living in the community

Fecal incontinence (FI) is a socially debilitating condition, resulting in considerable embarrassment, social isolation, loss of employment and causing symptoms that can significantly affect a woman's daily activities and quality of life. Little is known about the prevalence of FI amongst women in the general community. Furthermore, little is known about the possible association between FI and urinary incontinence (UI).

The aims of this study were to document the age-specific prevalence of FI in community dwelling women using a validated questionnaire and to determine its relationships with child birth (parity and instrumental delivery) and UI, taking into account age and body mass index.

442 Victorian women, mean age 59 years, range 26 to 82 years, provided information for this study. These women had previously been recruited from the community by us for a large cross-sectional women's health study and had agreed to participate in further research. The study was entirely questionnaire based.

The Pelvic Floor Distress Inventory (PFDI) questionnaire was used to estimate prevalence of FI. This is a condition-specific, validated questionnaire for women with disorders of the pelvic floor that serves the role of both a symptom inventory for pelvic organ prolapse, fecal and UI and a measure of the degree of bother and distress caused by the symptoms.

Findings

Loose FI was reported by 20.7% of the women and well-formed FI was reported by 4.5% . The prevalence of FI increased with age up to the age of 75 years for both types of FI. Nearly two-thirds of the women with loose as well as well-formed FI reported co-existing urinary incontinence. Mixed urinary incontinence was the predominant form, followed by stress-only and then urge-only urinary incontinence associated with both types of FI.

Summary

This study confirms that FI is a common condition, affecting about 20% of adult women in the community and shows that the prevalence increases with age. Whereas being parous was not associated with an increased risk of any FI, women with loose FI, but not well-formed FI, were more likely to have urinary incontinence independent of their age and weight. Therefore it is important that clinicians consider the possibility of FI, especially in women with urinary incontinence.

Botlero R, Bell RJ, Urquhart D, Davis SR Menopause 2011 Jun;18(6):685-9