Prevalence of and Factors Associated with Fecal Incontinence in a Large Community Study of Older Individuals

Quander, Carline; Morris, Martha Clare; Melson, Joshua; Bienias, Julia L.; Evans, Denis A.

doi:10.1111/j.1572-0241.2005.30511.x

Cited by 99 publications

(85 citation statements)

References 26 publications

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“…While studies (14,15) of the relationship between AI and diabetes have had conflicting results, we found that AI was associated with having diabetes among obese women only, whereas the relationship between AI and diabetes in women who were not obese was not statistically significant.…”

Section: Prevalence Of Pfds Among Women With Diabetescontrasting

confidence: 88%

“…It has been suggested that the most likely reason for the increase in risk is microvascular compromise, leading to damage to the urethral sphincter mechanism and bladder sensitivity, and that stricter glycemic control may reduce the risk or severity of urinary incontinence (13). Studies (14,15) of the relationship between anal incontinence and diabetes have had conflicting results.…”

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confidence: 99%

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Pelvic Floor Disorders, Diabetes, and Obesity in Women

et al. 2007

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OBJECTIVE -We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women.RESEARCH DESIGN AND METHODS -Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report. Women were categorized hierarchically as nonobese/nondiabetic (reference), nonobese/ diabetic, obese/nondiabetic, and obese/diabetic. CONCLUSIONS -Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFDs. RESULTS Diabetes Care 30:2536-2541, 2007D iabetes, obesity, and incontinence are all common health problems for women in the U.S. It has been estimated that 9.7 million, or 8.8%, of all women aged Ն20 years had diabetes in 2005 (1), while almost 50% may experience urinary incontinence in their lifetime (2). In [2003][2004]28.6% of women were overweight and 33.2% were obese (3). Urinary incontinence alone accounts for the expenditure of up to 19.5 billion dollars annually in the U.S. (4) and can have a significant impact on the quality of womens' lives (5).Studies (6 -12) have demonstrated the association between urinary incontinence and diabetes, and some (11,12) have found that women who used insulin were more likely to be incontinent than women with diabetes who did not require insulin, but the mechanisms are unclear. It has been suggested that the most likely reason for the increase in risk is microvascular compromise, leading to damage to the urethral sphincter mechanism and bladder sensitivity, and that stricter glycemic control may reduce the risk or severity of urinary incontinence (13). Studies (14,15) of the relationship between anal incontinence and diabetes have had conflicting results.Strong associations between obesity and both urinary and fecal incontinence have been reported (16 -24). The pathophysiologic basis posited for this relationship lies in the significant correlation between BMI and intra-abdominal pressure, suggesting that obesity may stress the pelvic floor secondary to a chronic state of increased pressure (25). Weight loss has been shown to improve incontinence in obese women (26 -28).In this secondary analysis of data from the KP CARES (Kaiser Permanente Continence Associated Risk Epidemiology Study) study, we examined associations between female pelvic floor disorders (PFDs) (stress urinary incontinence [SUI], overactive bladder [OAB], and anal incontinence [AI]) and diabetes and obesity. Pelvic organ prolapse was excluded from these analyses due to insufficient power to assess the associations of interest for this condition. We sought to evaluate the relative importance of the associations between diabetes and obesity in their contributions to PFDs. RESEARCH DESIGN AND METHODS -Kai...

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Section: Prevalence Of Pfds Among Women With Diabetescontrasting

confidence: 88%

mentioning

confidence: 99%

Pelvic Floor Disorders, Diabetes, and Obesity in Women

et al. 2007

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“…Not surprisingly, stroke survivors perceived their general health to be poorer than the non-stroke population, and a larger proportion also reported having difficulties with daily activities (Table 1). 8 In the overall population major fecal incontinence (soiling of underwear or more on a monthly basis) was reported in 1.5% (n=580). Stroke survivors reported a significantly higher prevalence of any fecal incontinence than the non-stroke population, 7.4% compared with 2.9% (see Table 1).…”

Section: Comparison Between the Stroke And Non-stroke Populationmentioning

confidence: 98%

Isolated Urinary, Fecal, and Double Incontinence: Prevalence and Degree of Soiling in Stroke Survivors

Brittain

Perry

Shaw

et al. 2006

J American Geriatrics Society

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Objectives: To investigate the prevalence of isolated urinary and fecal, and double incontinence in community living stroke survivors and to assess the degree of soiling. Residents living in institutional settings were excluded. Measurements:Respondents were asked about previous stroke, urinary and bowel symptoms, general health and demographic details including age, sex and ethnicity.Urinary incontinence was defined as leakage several times a month or more often.Major fecal incontinence was defined as soiling of underwear, outer clothing, furnishings or bedding several times a month or more often.Results: A 65% response rate to the postal survey was obtained with the return of 39, 519 eligible questionnaires, with 4% (n=1483) reporting stroke. Five percent of stroke survivors reported major fecal incontinence, with 4.3% reporting both fecal and urinary incontinence and 0.8% reporting isolated fecal incontinence. Major fecal incontinence was four and a half times more prevalent in stroke survivors than the non-stroke population, and stroke survivors were also twice as likely to report soiling of furnishings or bedding. The presence of fecal incontinence in both the stroke and non-stroke population is influenced by functional limitations. ConclusionsFecal incontinence is common in stroke survivors and the degree of soiling can be considerable. Future research needs to explore the impact fecal incontinence can have on the lives of stroke survivors and on how it can best be managed in those living in the community.

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“…Medical conditions such as diabetes, diarrhea, obesity, neurologic diseases, and urinary incontinence may result in or contribute to the symptoms of fecal incontinence. 1,2,6 In some patients, the etiology of fecal incontinence can be multifactorial. It is critical to establish the cause of incontinence because it is an important determinant of the treatment approach.…”

Section: Current Management Of Fecal Incontinencementioning

confidence: 99%

“…A prevalence up to 12% has been previously reported. 1,2 Men and women of all ages can be affected by fecal incontinence, although studies suggest it is more prevalent with increasing age. 3 In a large community-based study, the prevalence of fecal incontinence was 0.9% in adults between the ages of 40 and 64 years and 2.3% in adults older than 65 years.…”

Section: Introductionmentioning

confidence: 99%