Prevalence of functional bowel disorders and faecal incontinence: an Australian primary care survey

Abstract

AimInterest in functional bowel disorders (FBDs) and faecal incontinence (FI) has increased amongst coloproctologists. The study aimed to assess the prevalence of FBDs and FI (including its severity) among Australian primary healthcare seekers using objective criteria.MethodA cross‐sectional survey was conducted in a primary care setting in Sydney, Australia. A self‐administered questionnaire was used to collect demographic information and diagnose FBDs (irritable bowel syndrome, constipation, functional bloating and functional diarrhoea) based on Rome III criteria. The severity of FI was determined using the Vaizey incontinence score. Associations with medical/surgical history and healthcare utilization were assessed.ResultsOf 596 subjects approached, 396 (66.4%) agreed to participate. Overall, 33% had FBD and/or FI. Irritable bowel syndrome was present in 11.1% and these participants were more likely to report anxiety/depression (P < 0.01) and to have had a previous colonoscopy (P < 0.001) or cholecystectomy (P = 0.02). Functional constipation was present in 8.1%, and functional bloating and functional diarrhoea were diagnosed in 6.1%, and 1.5%, respectively. FI was present in 12.1% with the majority (52%) reporting moderate/severe incontinence (Vaizey score > 8). Participants with FI were more likely to have irritable bowel syndrome, urinary incontinence and previous anal surgery (P < 0.01).Conclusion FBDs and FI are prevalent conditions amongst primary healthcare seekers and the needs of those affected appear to be complex given their coexisting symptoms and conditions. Currently, the majority do not reach colorectal services, although increased awareness by primary care providers could lead to sufferers being referred for specialist management.

Motility/Neurogastroenterology

“…The median age was 54 years (range 22-81), and 12 patients were female. Indications for performing esophageal manometry and pH studies included gastroesophageal reflux (11), atypical chest pain (1), dysphagia (4), and chronic cough (1). Seven patients underwent either pH studies or manometry alone, while 9 patients underwent both procedures in the one session.…”

“…Initial outcomes in a new functional bowel and anorectal disorder clinic in southeast Queensland C KEOGH, C GILLESPIE Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland Functional bowel and anorectal disorders are more prevalent than previously thought [1], and they cause significant morbidity and impact on quality of life [2]. There is controversy in the management of these disorders.…”

Emerging treatments in neurogastroenterology: eluxadoline – a new therapeutic option for diarrhea‐predominant IBS

“…In the Phase 2 study, which involved four separate doses of eluxadoline (5, 25, 100, or 200 mg) or placebo given to 807 IBS-D patients twice daily over 12 weeks, adverse events (AEs) were similar for placebo and the lower three doses of the study medication (5,25, and 100 mg). At least one treatment-related AE was identified in 49% of those randomized to placebo compared with 44%, 51%, and 44% randomized to the 5-, 25-, or 100-mg doses, respectively (n.s.).…”

“…Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal (GI) disorder that affects up to 15% of the world's population. [1][2][3][4][5] Irritable bowel syndrome can be diagnosed using a combination of characteristic symptoms, the absence of warning signs on history or examination, and the Rome criteria, now in its third iteration. 6 The cardinal symptom of IBS is that of abdominal pain or discomfort.…”

A prospective “bottom up” study of the costs of faecal incontinence in ambulatory patients

“…It is reported to affect 7.7% of males and 8.9% of females within ambulant, community dwelling adults . However, surveys completed within primary health care settings report the prevalence to be even higher at 12.1‐36.2% …”