Fecal Incontinence

Ng, Kheng‐Seong; Sivakumaran, Yogeesan; Nassar, Natasha; Gladman, Marc A.

doi:10.1097/dcr.0000000000000514

Cited by 167 publications

(58 citation statements)

References 60 publications

(71 reference statements)

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“…International studies and studies in Scandinavia have reported the prevalence of urinary incontinence in similar groups to be equally high or higher (Buckley et al, 2010;Ebbesen et al, 2013;Milsom et al, 2014;Sorbye et al, 2009;Spigset et al, 1989) and faecal incontinence to be considerably lower (Finne-Soveri et al, 2008;Ng et al, 2015;Roberts et al, 1999;Rommen et al, 2012;Wu et al, 2015) than the prevalence of toileting difficulties reported in our study. Our study provides information on challenges experienced and also on the need for help caused by these challenges, but we do not have information on whether assisting needs are linked specifically to toilet visits, urinary incontinence and/or faecal incontinence.…”

Section: Discussionsupporting

confidence: 47%

“…Even so, several studies have assessed urinary and/or faecal incontinence (Buckley et al, 2010;Ng, Sivakumaran, Nassar, & Gladman, 2015). One European study of community-dwelling older people of both genders receiving formal in-home care reported the prevalence of urinary incontinence to be 46% (Du Moulin, Hamers, Ambergen, Janssen, & Halfens, 2008), while it is reported to be 37% among community-dwelling older people of both genders receiving formal in-home care in Norway (Sorbye et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

et al. 2019

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Aim To estimate the prevalence of toileting difficulties over time among older people (≥70 years) with and without dementia receiving formal in‐home care at baseline and to explore whether dementia at baseline was associated with toileting difficulties at the last assessment when adjusting for relevant covariates. We hypothesize that those with dementia have a higher prevalence and that baseline dementia is associated with toileting difficulties at last follow‐up. Design A longitudinal observational study with three assessments over 36 months. Older people (≥70 years) from 19 Norwegian municipalities with in‐home care needs were included. The participants and their next of kin were interviewed. Method In total, 1,001 (68% women) persons with a mean ( SD ) age 83.4 (5.7) years participated at baseline. Toileting difficulties were assessed using Lawton and Brody's Physical Self‐Maintenance Scale and Individual Nursing and Care Statistics. Information on physical comorbidity, number of prescribed drugs, cognitive function and formal care given was included. Dementia was diagnosed based on all information gathered. Results At all time points, toileting difficulties were more prevalent in people with than without dementia. In adjusted analyses, dementia at baseline was associated with toileting difficulties at the last assessment. Nursing home admission was associated with increased odds for toileting difficulties.

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Section: Discussionsupporting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

et al. 2019

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“…1 FI is associated with a substantial degree of embarrassment, hygiene issues, poor self-esteem, and significantly-impaired quality of life. 2 Although there is controversy as to whether women are more likely to develop FI than men, 3 women potentially have unique risk factors for FI, specifically anal sphincter trauma secondary to obstetric injury and pelvic floor changes related to menopause.…”

Section: Introductionmentioning

confidence: 99%

Menopausal Hormone Therapy Is Associated With Increased Risk of Fecal Incontinence in Women After Menopause

et al. 2017

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Background & Aims Low estrogen levels could contribute to development of fecal incontinence (FI) in women after menopause by altering neuromuscular continence mechanisms. However, studies have produced conflicting results on the association between menopausal hormone therapy (MHT) and risk of FI. Methods We studied the association between MHT and risk of FI among 55,828 post-menopausal women (mean age 73 years) who participated in the Nurses’ Health Study, enrolled since 2008, with no report of FI. We defined incident FI as a report of at least 1 liquid or solid FI episode per month during 4 years of follow up from self-administered, biennial questionnaires, administered in 2010 and 2012. We used Cox proportional hazards models to calculate multivariate-adjusted hazard ratios (HRs) and 95% CIs for FI risk in women receiving MHT, adjusting for potential confounding factors. Results During more than 185,000 person-years of follow up, there were 6834 cases of incident FI. Compared with women who never used MHT, the multivariate HR for FI was 1.26 (95% CI, 1.18–1.34) for past users of MHT and 1.32 (95% CI, 1.20–1.45) for current users. The risk of FI increased with longer duration of MHT use (P trend ≤.0001) and decreased with time since discontinuation. There was an increased risk of FI among women receiving MHT that contained a combination of estrogen and progestin (HR, 1.37; 95% CI 1.10–1.70) compared to estrogen monotherapy. Conclusions Current or past use of MHT was associated with a modestly increased risk of FI among post-menopausal women in the Nurses’ Health Study. These results support a potential role for exogenous estrogens in the impairment of the fecal continence mechanism.

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“…Fecal incontinence is a debilitating condition that affects approximately 2%–20% of the adult population [ 1 2 ]. It is more common in females, and with advancing age, it is the second most common cause of admission to a nursing home [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological Basis of Fecal Incontinence and Its Implications for Treatment

Weledji

2017

Ann Coloproctol

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The majority of patients with neuropathic incontinence and other pelvic floor conditions associated with straining at stool have damage to the pudendal nerves distal to the ischial spine. Sacral nerve stimulation appears to be a promising innovation and has been widely adopted and currently considered the standard of care for adults with moderate to severe fecal incontinence and following failed sphincter repair. From a decision-to-treat perspective, the short-term efficacy is good (70%-80%), but the long-term efficacy of sacral nerve stimulation is around 50%. Newer electrophysiological tests and improved anal endosonography would more effectively guide clinical decision making.

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Fecal Incontinence

Cited by 167 publications

References 60 publications

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

Menopausal Hormone Therapy Is Associated With Increased Risk of Fecal Incontinence in Women After Menopause

Electrophysiological Basis of Fecal Incontinence and Its Implications for Treatment

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