Objective-This study estimates the prevalence of fecal incontinence (FI) in overweight and obese women with urinary incontinence and compares dietary intake in women with and without FI.
Study Design-A total of 336 incontinent and overweight women in the Program to ReduceIncontinence by Diet and Exercise clinical trial were included. FI was defined as monthly or greater loss of mucus, liquid, or solid stool. Dietary intake was quantified using the Block Food Frequency Questionnaire.Results-Women had a mean (± SD) age of 53 ± 10 years, body mass index of 36 ± 6 kg/m 2 , and 19% were African American. Prevalence of FI was 16% (n = 55). In multivariable analyses, FI was independently associated with low fiber intake, higher depressive symptoms, and increased urinary tract symptoms (all P < .05).Conclusion-Overweight and obese women report a high prevalence of monthly FI associated with low dietary fiber intake. Increasing dietary fiber may be a treatment for FI. Keywords diet; fecal incontinence; female; food frequency questionnaire; obesity; stress incontinence; urge incontinence; urinary incontinence; weight loss Fecal incontinence (FI) is a common condition that results in significant physical and psychological disability. 1-3 The reported prevalence of FI varies considerably depending on the population studied and definition of incontinence. In population-based samples, the prevalence of FI has been reported to be 2-12% depending on the age of the cohort. 1-6More than 50% of US women are overweight (body mass index [BMI], 25-30 kg/m 2 ) or obese (BMI, ≥ 30 kg/m 2 ), and the prevalence of obesity is increasing by almost 6% per year. Although there are limited studies evaluating risk factors for FI, evidence suggests that obesity may be one of the strongest modifiable independent risk factors for FI in women. 4,9-11 In population-based observational studies, FI is reported to be approximately 50% more prevalent in obese compared with normal-weight women. 4,9-11 Other potential risk factors for FI in women include: age, parity, mode of delivery, impairments in activities of daily living, and comorbid diseases. [4][5][6]9,12 Although there are minimal data on the effect of weight loss on FI, clinical trials and observational studies suggest that weight loss may be an effective treatment for urinary incontinence (UI) and may prevent incident UI in women. 13-17 Women who undergo bariatric surgery or nonsurgical weight loss have had improvements in UI and FI frequency and severity. 13,17,18 There are few data to support improved outcomes with dietary changes for FI. Dietary modifications are often included as an early treatment strategy for FI, but minimal data exist to guide the recommendations on types of dietary changes. 19 Increasing soluble fiber intake has been shown to improve FI. 20 Overweight and obese women are reported to consume less dietary fiber than normal-weight, age-and height-matched women. 21 However, more data are needed on the effect of increasing dietary fiber on FI. Therefore, we estimat...