Prevalence of anorectal dysfunction in women attending health care services

Abstract

The aim of this study was to assess the prevalence of different bowel symptoms (constipation, faecal incontinence and faecal evacuation dysfunction) and associated urinary symptoms in women attending health care services. All women attending colposcopy clinics and general gynaecology clinics in a district general hospital in the southwest of England were invited to participate in the study. In addition, women attending the local family planning clinic were also recruited. Women attending these clinics routinely completed a history sheet and were asked to complete the Birmingham Bowel and Urinary Symptoms Questionnaire. Two hundred women participated in the study: 116 (64.4%) had at least one bowel symptom from the list in the questionnaire and 57 (31.6%) of women thought they had a bowel problem but only 26 (14.4%) consulted their family doctor regarding the problem while four (2.2%) were referred for specialist opinion. Six were unsure about their bowel symptoms. There were 46 (25.5%) of women who had constipation, 99 (55%) had faecal incontinence and 97 (53.8%) complained of faecal evacuation dysfunction. Only 48 (26.6%) of women were free of any bowel complaint. One patient with faecal incontinence discussed her problem with her midwife but no further action was taken as she was too embarrassed to discuss it with her doctor. Seventy-eight (43.3%) of patients had urinary symptoms. Fifty-five (30.5%) thought they had a urinary problem but only 29 (16.1%) consulted their doctor and 17 (9.4%) were referred for specialist opinion. Sixty-one (33.8%) of those who admitted to have urinary incontinence also had faecal incontinence. Forty-nine (27.2%) of the patients were free of all symptoms. The mode of delivery as well as previous surgery did not have any influence on urinary incontinence nor on anal incontinence. This study has demonstrated a high prevalence of bowel symptoms in women attending health care services.

Pelvic Floor Rehabilitation in Anal Incontinence

“…In patients from gastroenterology and gynecology clinics in Switzerland, AI was more prevalent among women (7.5%) [24]. A prevalence of FI higher than 55% was found among women attending gynecology clinics and a local family planning clinic in the UK [25]. A lower prevalence of FI (10.4%) was observed in a sample of 4815 women aged from 82 to87 years living in Australia [26].…”

“…The most cited risk-factors or predictors associated with AI are female gender [15,24,25], advanced age [16], perineal and surgical lesions combined with a feeling of incomplete defecation [27], multiple births [28], and anorectal and urogynecologic surgeries [17]. In addition, other authors have also cited idiopathic factors, rectal prolapse, menopause, and traumas [29]; diarrhea whether infectious or not [17]; inflammatory bowel disease combined with abusive use of laxatives, fecal impaction, rectal neoplasia and neuropathy [30]; immobility and dementia [31]; neurological diseases and disorders such as multiple sclerosis and Parkinson disease [17]; fistulotomy and ileal pouch reconstruction [8]; and median episiotomy [31,14].…”

Prevalencia de la incontinencia fecal en centros de salud y casas de reposo

“…El estudio de la IF en la población general demuestra una prevalencia entre 1% y 7% 5 , la cual aumenta al ser estudiada en la población que acude a un centro de atención de salud por otro motivo 6 . Al considerar a los mayores de 65 años esta cifra se eleva hasta 15%.…”

Kontinenzstörungen nach Analeingriffen – ein relevantes Problem?

“…Zahlen aus den USA weisen für die anal gesunde Normalbevölkerung eine Prävalenz von 0,5-2% bei jünge-ren Patienten (< 65 Jahre) auf, die im höheren Lebensalter auf > 4% ansteigt [80]. Eine englische Kohortenstudie berichtet bei Frauen über eine Prävalenz von Kontinenzstörungen bis zu 55% [12]. Eine einheitliche Definition und Bewertung des Begriffs "Stuhlinkontinenz" fehlen derzeit, so dass die Beurteilung einer Kontinenzstörung in allen Publikationen variiert.…”