Diet Modifications in Older Women With Fecal Incontinence: A Qualitative Study

Abstract

Objective The aim of the study was to investigate dietary modification strategies used by community-dwelling older women to manage their fecal incontinence (FI). Methods We conducted a qualitative study with focus groups wherein women 65 years and older with FI shared their experiences managing the condition. We explored the following: (1) association between diet and FI symptoms, (2) dietary strategies and modifications used by older women to manage FI, and (3) patient input about disseminating diet modification information and strategies. All focus groups were audio recorded, transcribed, coded, and qualitatively analyzed to identify relevant themes. Results Twenty-one women participated in 3 focus groups. All participants were aware that diet plays a key role in their experience of FI and women described a method of “trial and error” in identifying specific aspects of their diet that contributed to their FI symptoms. Women reported modifications including avoiding or limiting several foods and food categories, changing certain methods of food preparation, as well as varying the amounts and frequency of meals to manage their FI. Women articulated several suggestions including the importance of physician input, using a balanced approach when making recommendations, and the value of sharing individual experiences. Conclusions Older women with FI make several dietary modifications to manage their symptoms including limiting certain foods, changing methods of food preparation, and decreasing the amounts and frequency of meals. These strategies may be considered for inclusion in a diet modification plan that is culturally competent for older women with FI.

The Association Between Dietary Intake and Improvement of LARS Among Rectal Cancer Patients After Sphincter-Saving Surgery-A Descriptive Cohort Study

“…Another study surveyed the self-management methods of LARS after surgery according to the relationship reported by patients in postoperative daily life, and dietary patterns of low fat and high fiber were chosen by 14.8% of patients to manage defecation dysfunction ( 26 ). In addition, fried foods and greasy foods were also reported in past studies that they were likely to worsen the fecal incontinence( 27 , 28 ). It could be seen that too much intake of oil in daily life after surgery is harmful to the management of LARS.…”

“…Some other foods, such as fruits, vegetables and milk products, showed some relationship with LARS in other studies conducted in some European countries. Several studies reported that too much intake of milk products may aggravate dirrhea ( 17 , 27 , 28 ). The specific effect of vegetables and fruits on LARS were not consistent in previous studies.…”

A diet modification intervention for older women with fecal incontinence

“…Prior studies suggest that geriatric and women's health providers lack training in diet analysis and diet modification which is generally considered the purview of nutritionists 9 . However, older women with FI are looking to obtain reliable diet modification advice from their health care providers 6 . We have developed a simple but structured dietary intervention that could possibly be implemented by a wide range of providers who take care of women with FI.…”

“…A conceptual framework for the dietary intervention was created using the combined results of behavioral change theory framework, a systematic review on dietary interventions for FI, 5 and findings from a previously published focus group-based study. 6 (Table 1) An advisory group with expertise in geriatrics, nutrition, urogynecology and gastroenterology was developed to provide input on the intervention and to ensure that the intervention materials were compatible with national, demographic-specific, and nutritional recommendations. The process resulted in the creation of two educational booklets entitled "Dietary Management for ABL," "Ways to Naturally Increase Dietary Fiber," and "Food and Bowel Journal" (Supplementary Appendix S1).…”

Diet in Fecal Incontinence

“…The prolonged, segmental, and retrograde phasic activity induced by a fat meal may delay colon transit. Thus, meal composition influences colonic motor response [8,9].…”