The prevalence of faecal and double incontinence

Thomas, Thelma M.; Egan, Marian; Walgrove, A; Meade, T. W.

doi:10.1093/oxfordjournals.pubmed.a043715

Cited by 88 publications

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“…In contrast, two or more episodes of fecal incontinence per month were reported by 0.8% of patients presenting to primary care clinics in the UK (3). In an elderly (>65 yr) self-caring population, fecal incontinence occurred at least once a week in 3.7% of subjects and in more men than women (men:women = 1.5:1) (4).…”

Section: Epidemiologymentioning

confidence: 94%

Diagnosis and Management of Fecal Incontinence

Rao

2004

Am J Gastroenterology

284

295

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DEFINITIONFecal incontinence is defined as either the involuntary passage or the inability to control the discharge of fecal matter through the anus. Clinically there are three subtypes (a) passive incontinence-the involuntary discharge of stool or gas without awareness; (b) urge incontinence-the discharge of fecal matter in spite of active attempts to retain bowel contents, and (c) fecal seepage-the leakage of stool following otherwise normal evacuation. The severity of incontinence can range from the unintentional elimination of flatus to the seepage of liquid fecal matter or sometimes the complete evacuation of bowel contents. Not surprisingly, these events cause considerable embarrassment, which in turn can lead to a loss of self-esteem, social isolation, and a diminished quality of life (1). EPIDEMIOLOGYAlthough fecal incontinence affects people of all ages, its prevalence is disproportionally higher in women, in the elderly, and in nursing home residents. Estimates of its prevalence vary greatly and depend on the clinical setting, the influence of social stigma, the definition of incontinence, and the frequency of occurrence.In the U.S. householder survey, frequent leakage of stool or fecal staining for more than 1 month was reported by 7.1% and 0.7% of the population, respectively (2). In contrast, two or more episodes of fecal incontinence per month were reported by 0.8% of patients presenting to primary care clinics in the UK (3). In an elderly (>65 yr) self-caring population, fecal incontinence occurred at least once a week in 3.7% of subjects and in more men than women (men:women = 1.5:1) (4). In contrast, 25-35% of institutionalized patients (5) and 10-25% of hospitalized geriatric patients (6) suffer from fecal incontinence. In the United States, fecal incontinence is the second leading cause for placement in nursing homes (6).In a survey of 2,570 households, comprising 6,959 individuals, the prevalence of at least one episode of incontinence during the previous year was 2.2%; among these 63% were women, 30% were >65 yr of age, 36% were incontinent of solid stool, 54% of liquid stool, and 60% of flatus (7). Furthermore, in another prospective survey of patients attending either a gastroenterology or a primary care clinic, over 18% reported fecal incontinence at least once a week (8). Only one third had ever discussed the problem with a physician (8). When stratified for the frequency of episodes, 2.7% of patients reported daily incontinence, 4.5% weekly, and 7.1% once per month (8). In another survey, fecal incontinence was associated with urinary incontinence in 26% of women attending a Uro/Gyn Clinic (9). A higher incidence of mixed fecal and urinary incontinence was also reported in nursing home residents (10, 11).The cost of health care related to fecal incontinence includes items that can be measured such as the evaluation, diagnosis and treatment of incontinence, medications, the use of disposable pads and other ancillary devices, skin care, and nursing care. Approximately $400 million/year we...

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Section: Epidemiologymentioning

confidence: 94%

Diagnosis and Management of Fecal Incontinence

Rao

2004

Am J Gastroenterology

284

295

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“…It is a devastating personal and social problem which causes emotional distress leading to social isolation and loss of self-confidence [2] . The prevalence rates of FI in the community vary between 2.2%-15% in adults [3][4][5][6][7] . It is widely accepted that many patients with anal incontinence do not seek medical advice, thus making the true prevalence uncertain.…”

Section: Introductionmentioning

confidence: 99%

Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia

Subasinghe

Navarathna

Samarasekera

2016

WJGPT

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AIM:To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients. METHODS:All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis (UC) or Crohn's disease (CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI (Vaizey score), and quality of life (IBD-Q) were collected. Data were analyzed using SPSS version 21. RESULTS:There were 184 patients (women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC (male/female ratio = 1:1.5) and a male preponderance for CD (male/female = 2:1). Forty-eight (26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women (n = 34) and 29.2% were men (n = 14) with an average age of 52.7 years (range, 20-78 years). Average age of onset of FI was 48.6 (range, 22-74) years. Ten percent (n = 5) reported regular FI. Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South AsiaDuminda Subasinghe, Navarathna Mudiyanselage Meththananda Navarathna, Dharmabandhu Nandadeva Samarasekera Duminda Subasinghe, Navarathna Mudiyanselage Meththananda Navarathna, Dharmabandhu Nandadeva Samarasekera, Department of Surgery, Faculty of Medicine, University Surgical Unit, the National Hospital of Sri Lanka, Colombo 08, Sri LankaAuthor contributions: Subasinghe D, Navarathna NMM and Samarasekera DN were involved in study planning, data collection and analysis, and writing of the manuscript; all authors read and approved the final manuscript.Institutional review board statement: This study was approved by the ethics review committee of the National Hospital of Sri Lanka.Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment. Conflict-of-interest statement:The authors of this manuscript having no conflicts of Interest to disclose. Data sharing statement:There is no additional data available.Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/ licenses/by-nc/4.0/ Prospective StudyIncontinence to flatus was seen in 33.3% (n = 16), to liquid faeces in 56.2% (n = 27), to solid faeces in 6.2% (n = 3) and to all three in 4.1% (n = 2). Twenty-one ...

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“…Faecal continence depends on several factors including intact anorectal sensation, motor innervation and an anatomically intact sphincter complex [5]. It mainly affects women after childbirth.…”

Section: Introductionmentioning

confidence: 99%

Is a morphologically intact anal sphincter necessary for success with sacral nerve modulation in patients with faecal incontinence?

et al. 2007

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Objective Sacral nerve modulation (SNM) for the treatment of faecal incontinence was originally performed in patients with an intact anal sphincter or after repair of a sphincter defect. There is evidence that SNM can be performed in patients with faecal incontinence and an anal sphincter defect.Method Two groups of patients were analysed retrospectively to determine whether SNM is as effective in patients with faecal incontinence associated with an anal sphincter defect as in those with a morphologically intact anal sphincter following anal repair (AR). Patients in group A had had an AR resulting in an intact anal sphincter ring. Group B included patients with a sphincter defect which was not primarily repaired. Both groups underwent SNM. All patients had undergone a test stimulation percutaneous nerve evaluation (PNE) followed by a subchronic test over 3 weeks. If the PNE was successful, a permanent SNM electrode was implanted. Follow-up visits for the successfully permanent implanted patients were scheduled at 1, 3, 6 and 12 months and annually thereafter.Results Group A consisted of 20 (19 women) patients. Eighteen (90%) had a positive subchronic test stimulation. Twelve patients had a successful SNM implant during middle-term follow-up. Group B consisted of 20 women. The size of the defect in the anal sphincter varied between 17% and 33% of the anal circumference. Fourteen (70%) had a positive subchronic test stimulation. Twelve patients had a successful SNM implant during middle-term follow-up. In both groups, the mean number of incontinence episodes decreased significantly with SNM (test vs baseline: P = 0.0001, P = 0.0002). There was no significant difference in resting and squeeze pressures during SNM in group A, but in group B squeeze pressure had increased significantly at 24 months. Comparison of patient characteristics and outcome between groups A and B revealed no statistical differences.Conclusion A morphologically intact anal sphincter is not a prerequisite for success in the treatment of faecal incontinence with SNM. An anal sphincter defect of <33% of the circumference can be effectively treated primarily with SNM without repair.

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The prevalence of faecal and double incontinence

Cited by 88 publications

References 0 publications

Diagnosis and Management of Fecal Incontinence

Diagnosis and Management of Fecal Incontinence

Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia

Is a morphologically intact anal sphincter necessary for success with sacral nerve modulation in patients with faecal incontinence?

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