Anal incontinence in women presenting for gynecologic care: Prevalence, risk factors, and impact upon quality of life

• Published in: American journal of obstetrics and gynecology Vol. 192; no. 5; pp. 1637 - 1642
• Main Authors: Boreham, Muriel K., Richter, Holly E., Kenton, Kimberly S., Nager, Charles W., Gregory, W. Thomas, Aronson, Michael P., Vogt, Val Y., McIntire, Don D., Schaffer, Joseph I.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01-05-2005; Elsevier
• Subjects: Adult; Aging; Anal incontinence; Biological and medical sciences; Body Mass Index; Cohort Studies; Constipation; Constipation - complications; Delivery of Health Care; Diarrhea - physiopathology; Fecal Incontinence - complications; Fecal Incontinence - epidemiology; Fecal Incontinence - physiopathology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gynecology; Gynecology. Andrology. Obstetrics; Humans; Inflammatory Bowel Diseases - complications; Irritable bowel syndrome; Logistic Models; Medical sciences; Middle Aged; Odds Ratio; Other diseases. Semiology; Prevalence; Quality of Life; Risk Factors; Severity of Illness Index; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surveys and Questionnaires; Anal incontinence; Prevalence; Constipation; Irritable bowel syndrome; Quality of life; Human; Gynecology; Epidemiology; Obstetrics; Care; Risk factor; Digestive diseases; Intestinal disease; Adult; Female; Anal incontinence Quality of life Prevalence Irritable bowel syndrome Constipation; Anorectal disease
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2004.11.030

The purpose of this study was to estimate the prevalence and impact upon quality of life of anal incontinence (AI) in women aged 18 to 65.
Consecutive women presenting for general gynecologic care were given a bowel function questionnaire. Women with AI were prompted to complete the Fecal Incontinence Severity Index (FISI) and Fecal Incontinence Quality of Life Scale (FIQL).
The cohort was composed of 457 women with a mean age of 39.9 ± 11 years. AI prevalence was 28.4% (95% CI 24.4–32.8). After logistic regression, IBS (OR 3.22, 1.75–5.93), constipation (OR 2.11, 1.22–3.63), age (OR 1.05, 1.03–1.07), and BMI (OR 1.04, 1.01–1.08) remained significant risk factors. The mean FISI score was 20.4 ± 12.4. Women with only flatal incontinence scored higher, and women with liquid loss scored lower on all 4 scales of the FIQL.
AI is prevalent in women seeking benign gynecologic care, and liquid stool incontinence has the greatest impact upon quality of life.