Fecal Incontinence in the Elderly: FAQ

Abstract

Fecal incontinence (FI) is a common gastrointestinal (GI) complaint in patients aged 65 years and older. This evidence-based review article discusses the epidemiology, pathophysiology, evaluation, and management of FI in the geriatric population. We emphasize aging-related changes leading to and impacting evaluation and treatment of this symptom while incorporating the core geriatric principles of functional status and management aligned with patient preference and goals of care.

Prevalence of fecal incontinence (FI) and associated factors in institutionalized older adults

“…From the results of this research, it was observed that almost 43% of the institutionalized elderly presented involuntary losses of feces, a prevalence value that agrees with the ranges presented in literature, which generally vary between 33% and 65% (Saga et al, 2013;Shah et al, 2012;Zarate et al, 2008). However, the severity of the incontinence in this sample was higher, considering that most residents with FI did not present any episodes of continence, with liquid and solid stool losses (Aslan et al, 2009).…”

“…In this study, physical inactivity and immobility lost statistical significance when adjusted in the multivariate model. Regarding chronic diseases, it has already been reported that the increase in FI prevalence in the elderly is not explained by the higher presence of comorbidities (Shah et al, 2012). In this study, there were no associations between chronic diseases and FI, and only stroke was present in the multivariate model, as an adjustment variable.…”

“…Although it is a health issue frequently neglected, it affects between 2% and 20% of the elderly in community settings and prevalence increases considerably when an institution environment is considered (Aslan, Beji, Erkan, Yalcin, & Gungor, 2009;Leung & Rao, 2009;Leung & Schnelle, 2008;Saga, Vinsnes, Morkved, Norton, & Seim, 2013;Shah et al, 2012;Zarate, Lopez-Kostner, Vergara, Badilla, & Viviani, 2008). This problem entails a strong impact for health systems, as well as social impact to caregivers, family members, and on the health and life quality of the elderly (Leung & Rao, 2009;Shah et al, 2012).…”

“…Fecal incontinence (FI) is a common gastrointestinal complaint in elderly individuals, defined as the involuntary loss of stool or inability to control stool from expulsion, which is a social and hygienic problem (Norton, Whitehead, Bliss, Harari, & Lang, 2010;Shah, Chokhavatia, & Rose, 2012). Although it is a health issue frequently neglected, it affects between 2% and 20% of the elderly in community settings and prevalence increases considerably when an institution environment is considered (Aslan, Beji, Erkan, Yalcin, & Gungor, 2009;Leung & Rao, 2009;Leung & Schnelle, 2008;Saga, Vinsnes, Morkved, Norton, & Seim, 2013;Shah et al, 2012;Zarate, Lopez-Kostner, Vergara, Badilla, & Viviani, 2008).…”

Randomized Controlled Study of the Effects of 2 Fecal Management Systems on Incidence of Anal Erosion

“…Etiologic factors for intractable diarrhea include diabetes mellitus, multiple sclerosis, scleroderma, and other systemic disorders. 1 Other etiologic factors include infl ammatory bowel diseases, antibiotic use, lactulose, tube feedings, and infectious cases, including Clostridium diffi cile . Fecal incontinence leads to skin breakdown commonly referred to as incontinence-associated dermatitis (IAD).…”