Consensus Report Highlights Incontinence

Abstract

AS MANY AS 25% OF ADULTS WILL experience urinary or fecal incontinence in their lifetime, yet more than half will go untreated despite the availability of interventions to address these disorders, according to a consensus report published by the National Institutes of Health in December. In addition to having a devastating effect on individuals’ personal lives, these conditions have a huge economic impact, with the cost of urinary incontinence alone estimated to be about $20 billion in 2000. The stigma associated with being unable to control one’s bladder or bowels often leads persons with these conditions to limit their activities and withdraw from their loved ones, rather than seek treatment. Yet, if asked, most individuals will report their problems to their physician, according to the report (http://consensus.nih.gov/2007 /IncontinenceStatementDRAFT121207 .pdf). Primary care physicians therefore have a key role to play in reducing the burden of theses conditions, the panel concluded. Physicians are urged to ask questions about patients’ bowel and urinary tract function as part of routine care. The panel advises physicians to focus on questions about the frequency and volume of urination or bowel movements, assess whether patients are distressed by their symptoms, and determine if the patient would like to pursue treatment, which may include surgery for urinary incontinence or biofeedback therapy for fecal incontinence.