Prevalence Of Fecal Incontinence Research Articles

Fecal incontinence risk factors and pregnancy.

We conducted an analysis on 231 pregnant women. A proctologist examined the patients three times: in the 1st trimester (within the first 15 weeks), in the 3rd trimester (29-40 weeks), and 12 months after childbirth. The total number of fecal incontinence observations among women included in the study was 66 cases (28.6%), detected at the final visit. Risk factors for fecal incontinence with a high probability were age over 36 years (P = 0.001), low physical activity (P = 0.034), three or more pregnancies resulting in childbirth (P = 0.022), history of hemorrhoids (P = 0.027), perianal discomfort on the first visit (P = 0.045), and constipation on the first visit (P = 0.006). Factors such as being overweight, marital status, education, living conditions, living area, and infant size did not have significance for fecal incontinence. Pregnancy- and obstetric-related risk factors contributing to fecal incontinence are multifactorial, including factors such as multiple childbirths with trauma to the pelvic muscles or anal sphincter muscles, chronic constipation, age, and vaginal deliveries. However, currently, there is no clear concept for the prevention of fecal incontinence in pregnant women. The prevalence of fecal incontinence among pregnant women is 12.9%, which increases to 28.6% one year after childbirth. The most common complaint was involuntary passage of intestinal gas. Risk factors for fecal incontinence with a high probability included being over 36-years old, low physical activity, three or more pregnancies resulting in childbirth, a history of hemorrhoids, perianal discomfort, and constipation in the 1st trimester of pregnancy.

Exam 1: Global Prevalence of Fecal Incontinence in Community-Dwelling Adults: A Systematic Review and Meta-analysis

Exam 1: Global Prevalence of Fecal Incontinence in Community-Dwelling Adults: A Systematic Review and Meta-analysis

Centrally Distributed Adiposity as a Modifiable Risk Factor for Fecal Incontinence: United States Population-based Analysis

Fecal incontinence (FI) is highly prevalent with substantial impacts on quality of life and healthcare utilization. The impact of obesity on FI remains unclear, with differing conclusions using BMI as risk factor. We aimed to determine the association between obesity and FI, and whether this relationship is dependent on the distribution of adiposity (waist circumference-to-height ratio, WHtR). This was a population-based analysis of the National Health and Nutrition Examination Survey, including participants who responded to the bowel health survey in 2005-2010. FI was defined by the accidental bowel leakage of solid stool, liquid, or mucus at least once in the past month. Stepwise multivariable logistic regression models were constructed to assess risk factors for FI. A total of 7,606 participants were included, with an overall FI prevalence of 9.2%. When stratified by quartiles of body measurements, FI was increasingly prevalent from 1st to 4th quartile for both WHtR (range: 5.3%-12.5%) and BMI (range: 7.1%-10.5%). WHtR was associated with FI and was a stronger predictor than BMI in all quartiles of body measurement. On multivariable analysis, WHtR remained a significant predictor of FI comparing the 4th to the 1st quartile of body measurements (OR:1.77, CI:1.11-2.80, p=0.017), whereas BMI was not. A WHtR cutoff of >0.592 optimized the Youden index in prediction of FI in the overall sample. WHtR was independently associated with increased odds of FI in this nationally representative sample of US adults, whereas BMI was not consistently correlated. This suggests bowel continence may depend more on how body mass is distributed.

Monitoring-Based Model for Personalizing Fecal Incontinence in Patients With Crohn's Disease: A Multicenter Inception Cohort Study.

Fecal incontinence (FI) is a common complaint that greatly affects the quality of life of patients with Crohn's disease (CD) and is associated with the clinical characteristics of CD. We aimed to identify risk factors related to FI and construct a risk prediction model for FI in patients with CD. This retrospective study included 600 Chinese patients with CD from 4 IBD centers between June 2016 and October 2021. The patients were assigned to the training (n = 480) and testing cohorts (n = 120). Two nomograms were developed based on the logistic regression and Cox regression models to predict the risk factors for FI in patients with CD. The discriminatory ability and accuracy of the nomograms were evaluated using the receiver operating characteristic (ROC) curves and the area under the ROC curves (AUCs). Additionally, the Kaplan-Meier survival curve was also used further to validate the clinical efficacy of the Cox regression model. The overall prevalence of FI was 22.3% (n = 134 of 600). In the logistic regression model, age at diagnosis (odds ratio [OR], 1.032; P = .033), penetrating behavior of disease (OR, 3.529; P = .008) and Perianal Disease Activity Index score >4 (OR, 3.068; P < .001) were independent risk factors for FI. In the Cox regression model, age at diagnosis (hazard ratio [HR], 1.027; P = .018), Montreal P classification (HR, 2.608; P = .011), and Perianal Disease Activity Index score >4 (HR, 2.190; P = .001) were independent predictors of the prevalence of FI over time. Two nomograms were developed to facilitate risk score calculation, and they showed good discrimination ability according to AUCs. In this study, we identified 4 risk factors related to the prevalence of FI and developed 2 models to effectively predict the risk scores of FI in CD patients, helping to delay the course of FI and improve the prognosis with timely intervention.

Faecal incontinence-a comprehensive review.

Faecal incontinence (FI) is a distressing and often stigmatizing condition characterised as the recurrent involuntary passage of liquid or solid faeces. The reported prevalence of FI exhibits considerable variation, ranging from 7 to 15% in the general population, with higher rates reported among older adults and women. This review explores the pathophysiology mechanisms, the diagnostic modalities and the efficiency of treatment options up to date. A review of the literature was conducted to identify the pathophysiological pathways, investigation and treatment modalities. This review provides an in-depth exploration of the intricate physiological processes that maintain continence in humans. It then guides the reader through a detailed examination of diagnostic procedures and a thorough analysis of the available treatment choices, including their associated success rates. This review is an ideal resource for individuals with a general medical background and colorectal surgeons who lack specialized knowledge in pelvic floor disorders, as it offers a comprehensive understanding of the mechanisms, diagnosis, and treatment of faecal incontinence (FI).

P1132 Fecal incontinence in Inflammatory Bowel Disease (IBD): associated factors and impact on the quality of life of patients in an IBD clinic in Switzerland

Abstract Background Literature on prevalence of fecal incontinence (FI) in inflammatory bowel disease (IBD) and associated factors has not been thoroughly studied. IBD is a chronic disease with high morbidity and significant impact on quality of life. Awareness of prevalence and associated factors of FI would make gastroenterologists more conscious of its burden, leading to targeted clinical assessment and treatment. Methods We conducted a cross-sectional study, looking at risk factors for FI and its impact on quality of life. The study population consisted of IBD patients aged from 16 to 80 years old in an IBD clinic in Switzerland. Patients with a stoma, a J-Pouch and an unspecified IBD were excluded. The survey had 53 questions, with demographics and main clinical variables. The quality of life of patients was assessed using the World Health Organization quality of life scale. Disease severity was measured based on the short Crohn’s disease activity index (SCDAI) for Crohn’s disease (CD) and using the simple clinical colitis activity index (SCCAI) for Ulcerative colitis (UC). Logistic regression was used to calculate crude and adjusted odds ratio (OR), applying 95% confidence intervals (CI). Results 450 questionnaires were randomly distributed. 392 patients met the inclusion criteria. 116 patients (29.5%) reported FI. Factors associated with FI included: age &amp;gt; 50 years old [OR 2.74 (CI: 1.57-3.89)]; one or more vaginal delivery [OR 2.49 (CI: 1.32-4.71)];disease duration &amp;gt; 15 years [OR 2.04 (CI: 1.31-3.16)], abdominal pain [OR 2.56 (CI: 1.60-4.09)], diarrhea [OR 3.70 (CI: 2.26-6.04)], blood in stool [OR 3.33 (1.88-5.89)], more than 3 bowel movements/day [OR 4.50 (CI: 2.79-7.26)],night bowel movements [OR 3.98 (CI: 2.36-6.71)] and an SCCAI ≥ 3 [OR 6.06 (CI: 2.62-14.02)]. There was also a positive association between the presence of one or more extraintestinal manifestation (EIM) [OR 1.64 (CI: 1.03-2.61)] and FI. General well-being [OR 2.61 (CI: 1.65-4.14)] was inversely associated with FI. Similarly, depression and anxiety were associated with FI, respectively; [OR 2.43 (CI: 1.27-4.68) and OR 1.88 (CI: 1.07-3.30)]. Noticeably, 35.3% of patients with FI could not hold their stools for more than 5 minutes, and 14.7% were unable to hold their stools for more than a minute. Conclusion FI was highly prevalent (29.5%) in our survey. Age, vaginal delivery, disease duration &amp;gt;15 years, abdominal pain, diarrhea, blood in stool, &amp;gt;3 bowel movements /day, night bowel movement, SCCAI ≥ 3, ≥ 1 EIM were associated with FI. The quality of life was significantly impacted, and anxiety and depression were associated with FI. These implications highlight the need for interventions aimed at enhancing physical and mental health outcomes among individuals with IBD.

The prevalence and predictors of geriatric giants in community-dwelling older adults: a cross-sectional study from the Middle East

The term “geriatric giants” refers to the chronic disabilities of senescence leading to adverse health outcomes. This study aimed to investigate the prevalence and predictors of geriatric giants in Southern Iran. The participants were selected from Bushehr city using a multistage cluster random sampling method. Demographic data were collected through interviews. Frailty, incontinence, immobility, depression, cognitive impairment, and malnutrition were measured by questionnaires and instruments. Finally, data from 2392 participants were analyzed. The prevalence of fecal incontinence was less than 1% among all participants and similar in men and women. In contrast, compared with men, women had higher prevalence of urinary incontinence (36.44% vs. 17.65%), depression (39.05% vs. 12.89%), anorexia and malnutrition (2.35% vs. 0.82%), immobility (8.00% vs. 2.5%), frailty (16.84 vs. 7.34), and pre-frailty (54.19 vs. 38.63%). The prevalence of dependence and cognitive impairment was also higher in women and considerably increased with the age of participants. In total, 12.07% of subjects were frail, and 46.76% were pre-frail. The prevalence of frailty exponentially increased in older age, ranging from 4.18% among those aged 60–64 years to 57.35% in those aged ≥ 80 years. Considering 95% confidence interval (CI), multivariate logistic regression revealed that low physical activity [odds ratio (OR) 31.73 (18.44–54.60)], cancer (OR 3.28 (1.27–8.44)), depression [OR 2.42 (1.97–2.98)], age [OR 1.11 (1.08–1.14)], waist circumference [OR 1.03 (1.01–1.06)], BMI [OR 1.07 (1.01–1.14)], MNA score [OR 0.85 (0.79–0.92)], polypharmacy [OR 2.26 (1.30–3.95)] and male gender [OR 0.63 (0.42–0.93)] were independently associated with frailty. White blood cell count (WBC), smoking, marital status, and number of comorbidities were not independently associated with frailty. Low physical activity was the strongest predictor of frailty, which may need more attention in geriatric care. Frailty, its predictors, and other components of geriatric giants were considerably more common among women and older ages.

Prevalence of Fecal Incontinence in Normal Pressure Hydrocephalus: A Prospective Evaluation of 100 Patients

Normal pressure hydrocephalus (NPH) is a frequent disease in elderly patients. The main symptoms are gait disturbance, urine incontinence, and cognitive decline. Fecal urgency and incontinence are described as rare additional symptoms; however, no exact numbers are known. The aim of this study was to investigate the prevalence of fecal disturbances in NPH patients. Patients who presented to our department with confirmed diagnosis of NPH between January and December 2021 were interviewed prospectively about fecal function. Additionally, the extent of gait disturbance, cognitive decline, ventriculomegaly (EvansIndex), disproportionate enlarged subarachnoid space hydrocephalus (DESH presence), age, gender, and length of history were documented. In those who were operated with a hydrocephalus shunt postoperative development of stool incontinence was followed up. One hundred patients were evaluated (67 males, 33 females, medium age 77.5years, medium Evans Index: 0.37; 87 with disproportionate enlarged subarachnoid space hydrocephalus). 97 patients showed gait disturbance, 84 cognitive decline, and 87 bladder dysfunctions. 78 patients had the complete Hakim triad. 32 patients complained about fecal incontinence (20 with urge incontinence, 12 with complete incontinence). Twenty nine patients were shunted, of which 17 (57%) recovered completely, 9 (31%) partially, and 3 (10%) did not show any change. Fecal urgency and incontinence is a frequent finding in NPH (32%) and is essential for the quality of life. In the general population, fecal incontinence in elderly is found in up to 15%. The more than two-fold higher prevalence in NPH patients and the high percentage of postshunted improvement suggests that NPH causes often directly fecal disturbance.

Co-occurrence of fecal incontinence with constipation or irritable bowel syndrome indicates the need for personalized treatment.

This study aimed to compare the prevalence and symptoms of fecal incontinence (FI) in relation to irritable bowel syndrome (IBS-associated FI), constipation (constipation-associated FI), and isolation (isolated FI). Data were analyzed from 3145 respondents without organic comorbidities known to influence defecation function from the general Chinese population who filled in the online Groningen Defecation and Fecal Continence questionnaire. FI, IBS, and constipation were evaluated with the Rome IV criteria. The prevalence of FI was 10.5% (n = 329) in the non-comorbidity group. After multivariable logistic regression analysis, IBS (odds ratio [OR]: 12.55, 95% confidence interval [CI]: 9.06-17.36) and constipation (OR: 4.38, 95% CI: 3.27-5.85) were the most significant factors contributing to FI. Based on this finding, 106/329 (32.2%) had IBS-associated FI, 119/329 (36.2%) had constipation-associated FI, and 104/329 (31.6%) had isolated FI. Among the 329 FI respondents, there was a high prevalence of IBS and constipation-related symptoms, including abdominal pain (81.5%) and abdominal bloating (77.8%) for IBS and straining during defecation (75.4%), incomplete defecation (72.3%), defecation blockage (63.2%), anal pain during defecation (59.3%), and hard stools (24%) for constipation. The patients with IBS-associated FI asked for specialists' help less frequently than those with isolated FI. Interestingly, among the patients with constipation-associated FI, 56.3% used anti-diarrhea medicine. The prevalence of IBS-associated FI, constipation-associated FI, and isolated FI is comparably high. It is important to diagnose and target the cause of FI to provide personalized and cause-targeting care instead of treating only the FI symptoms.

Fecal incontinence and associated pelvic floor dysfunction during and one year after the first pregnancy.

Obstetric anal sphincter injury is an important risk factor for postpartum fecal incontinence but few studies have reported fecal incontinence occurring, even during pregnancy. The first objective of this study was to examine the prevalence of fecal incontinence, obstructed defecation and vaginal bulging early and late in pregnancy and postpartum. The second objective was to assess the association between symptoms in pregnancy, delivery characteristics, and bowel and vaginal bulging symptoms at 1 year postpartum. This prospective cohort study was conducted between October 2014 and October 2017, including 898 nulliparous women enrolled with the maternity healthcare service in Örebro County, Sweden. The women responded to questionnaires regarding pelvic floor dysfunction in early and late pregnancy and at 8 weeks and 1 year postpartum. The data were analyzed using random effect logistic models estimating odds ratios (ORs) and generalized linear models estimating relative risks, with 95% confidence intervals (CIs). At 1 year postpartum, the prevalence of fecal incontinence, obstructed defecation and vaginal bulging was 6% (40/694), 28% (197/699) and 8% (56/695), respectively. Among women with vaginal delivery, the risk of fecal incontinence and vaginal bulging increased significantly both in late pregnancy, with ORs of 3.4 (95% CI 1.5-7.7) and 3.6 (95% CI 1.6-8.1), respectively, and at 1 year postpartum, with ORs of 5.0 (95% CI 2.1-11.5) and 8.3 (95% CI 3.8-18.1), respectively, compared with early pregnancy. Among all women, factors associated with increased prevalence of fecal incontinence 1 year postpartum were fecal incontinence during pregnancy (adjusted relative risk [aRR] 7.4; 95% CI 4.1-13.3), obstructed defecation during pregnancy (aRR 2.0; 95% CI 1.1-3.9) and concurrent obstructed defecation (aRR 2.4; 95% CI 1.3-4.5). This prospective study shows an increased risk of fecal incontinence by late pregnancy, suggesting that the pregnancy itself may be involved in the development of postpartum fecal incontinence. Obstructed defecation during pregnancy and postpartum was found to be associated with increased risk of fecal incontinence postpartum, indicating that postpartum fecal incontinence may be a result of incomplete bowel emptying.

To Investigate the Association between the Extent of Lateral Internal Anal Sphincterotomy and Postoperative Fecal Incontinence in Individuals with Chronic Anal Fissure

Background: The primary objective of this investigation was to evaluate the prevalence of fecal incontinence after surgery in individuals who underwent open lateral internal anal sphincterotomy up to the dentate line compared to those undergoing anal sphincterotomy (open internal) up to the height of the anal fissure. Methodology: This study was randomized and controlled and was carried out in Abbasi Shaheed Hospital, Karachi, at the department of surgery between February 2021 and July 2022. The study enrolled patients who were 15 years or older and presented to the outpatient department with chronic anal fissure, regardless of gender. Patients with concomitant anal disease, those with previous history of anorectal surgery &amp; those with systemic neurological disease leading to fecal incontinence were excluded. Analysis of the collected data was performed using SPSS version 23. For quantitative variables, such as age, standard deviation and mean were calculated. Conversely, the qualitative variables, such as gender, location of anal fissure, Browning and Park's classification of incontinence, and final outcome(i.e. fecal incontinence at 5th postoperative day), were assessed using percentages and frequency. Results: In this study, 198 individuals who are chorincally suffering from anal fissure were identified and divided into two groups, Group A and B, each consisting of 99 patients. Group A underwent an open lateral internal anal sphincterotomy up to the level of the dentate line (referred to as the "dentate line group"), while Group B received an open lateral internal anal sphincterotomy up to the height of the fissure (known as the "height of fissure group").Fecal incontinence was assessed and compared between both groups on 5th postoperative day by using Browning and Park’s classification. The findings of this investigation indicated that open lateral anal sphincterotomy up to the level of the dentate line was associated with an 11.1% incidence of fecal incontinence, while a 3% incidence of fecal incontinence was observed in individuals who underwent anal sphincterotomy (lateral internal) up to the height of the anal fissure. Practical Implication: present study suggests that lateral internal anal sphincterotomy up to the height of anal fissure may be associated with a lower risk of fecal incontinence compared to the dentate line group. Conclusion: The data obtained from this study suggested that open anal sphincterotomy (lateral internal) up to the height of the anal fissure was linked to reduced incidence rates of postoperative fecal incontinence on the fifth day after surgery, as compared to open anal sphincterotomy (lateral internal) up to the level of the dentate line. Therefore, this modification should be used in future regularly in order to reduce this morbidity. Keywords: Fecal incontinence, Chronic Anal Fissure, Sphincterotomy.

The Prevalence of Bowel and Bladder Function During Early Childhood: A Population-Based Study.

Our primary aim was to determine bowel and bladder function in children aged 1 month to 7 years in the general Dutch population. Second, we aimed to identify demographic factors associated with the presence of bowel and bladder dysfunction, and their coexistence. For this cross-sectional, population-based study, parents/caregivers of children aged from 1 month to 7 years were asked to complete the Early Pediatric Groningen Defecation and Fecal Continence questionnaire. Different parameters of bowel and bladder function were assessed using validated scoring systems such as the Rome IV criteria. The mean age of the study population (N = 791) was 3.9 ± 2.2 years. The mean age at which parents/caregivers considered their child fully toilet-trained was 5.1 ± 1.5 years. Prevalence of fecal incontinence among toilet-trained children was 12%. Overall prevalence of constipation was 14%, with a constant probability and severity at all ages. We found significant associations between fecal incontinence and constipation [odds ratio (OR) = 3.88, 95% CI: 2.06-7.30], fecal incontinence and urinary incontinence (OR = 5.26, 95% CI: 2.78-9.98), and constipation and urinary incontinence (OR = 2.06, 95% CI: 1.24-3.42). Even though most children are fully toilet-trained at 5 years, fecal incontinence is common. Constipation appears to be common in infants, toddlers, and older children. Fecal incontinence and constipation frequently coexist and are often accompanied by urinary incontinence. Increased awareness of bowel and bladder dysfunction in infants, toddlers, and young children is required to prevent these problems from continuing at older ages.

The prevalence and burden of Rome IV faecal incontinence in ulcerative colitis: A cross-sectional study.

Despite advances in ulcerative colitis (UC) therapies, a relatively undefined proportion of patients experience faecal incontinence (FI) in the absence of active inflammation. For this group, there remains a significant unmet need with a limited evidence base. We aimed to estimate the prevalence and impact of FI in UC. In a prospective cross-sectional study, patients with UC completed a series of validated questionnaires, including Rome IV FI criteria, an inflammatory bowel disease (IBD)-specific FI questionnaire (ICIQ-IBD), Hospital Anxiety and Depression Scale and IBD-Control. UC remission was defined as faecal calprotectin (FCP) ≤250 μg/g, or IBD-control 8 score ≥13 and IBD-Control-VAS ≥ 85. Of 255 patients with UC, overall, 20.4% fulfilled Rome IV criteria for FI. Rome IV FI prevalence did not differ between active and quiescent UC regardless of whether disease activity was defined by IBD-Control scores ± FCP (p = 0.25), or objectively with FCP thresholds of 250 μg/g (p = 0.86) and 100 μg/g (p = 0.95). Most patients (75.2%) reported FI when in 'remission' and during 'relapse' (90.6%) according to ICIQ-IBD. Those who reported FI according to both ICIQ-IBD and Rome IV definitions had higher anxiety, depression and worse quality-of-life (QoL) scores (p < 0.05). In those with Rome IV FI, there was a strong correlation between FI symptom severity and impaired QoL (r = 0.809, p < 0.001). The prevalence of FI in UC is high, even in remission, and associated with significant psychological distress, symptom burden and impaired QoL. These findings highlight the urgent need for further research and development of evidence-based treatments for FI in UC.

Prevalence of pelvic floor disorders in the Eastern Mediterranean region: A meta-analysis.

High prevalence of risk factors for pelvic floor disorders (PFD) in the Eastern Mediterranean may result in higher rates of prevalence of PFD in comparison to other regions. Despite individual studies, there are no clear statistics on the cumulative prevalence of PFDs in the East Mediterranean region. The aim of this study was to investigate the prevalence of PFDs in the Eastern Mediterranean region. A literature search without language restriction was conducted in PubMed, Cochrane database and Web of Science from 2016 to 01 June 2022. Cross-sectional and cohort studies that reported prevalence of urinary incontinence (UI), constipation, fecal incontinence (FI) and pelvic organ prolapse (POP) among women in the Eastern Mediterranean region were included. Study quality was assessed according to the Joanna Briggs Institute critical appraisal tool. Data were pooled and meta-analysed using a random effects model. CRD42021283127 RESULTS: The search yielded 390 articles, from which 12 studies containing 9905 patients were included. Five studies were high quality and seven were low quality. The prevalence of POP (12 studies, 9905 participants), UI (5 studies, 2340 participants), constipation (4 studies, 2045 participants) and FI (1 study, 166 participants) was 39% (95% CI 21-57; I2 99.8%), 48% (95% CI 16-80; I2 99.7%), 39% (CI 17-60; I2 99.1%) and 14% (95% CI 9-20) respectively. In meta-analysis pooling studies of mixed quality, a high prevalence of PFDs was seen in the Eastern Mediterranean region.PROSPERO No.: CRD42021283127.

Are quality of life, functional capacity, and urinary incontinence associated with fecal incontinence? The Fibra-BR Study

Objective: To assess the prevalence of fecal incontinence and its association with clinical, functional, and cognitive-behavioral variables, medication use, frailty, falls, and quality of life in community-dwelling older adults (aged 65 years or older). Methods: Cross-sectional, multicenter study carried out across 16 Brazilian cities. The question “In the last 12 months, did you experience fecal incontinence or involuntary passage of stool?” was defined as the indicator variable for fecal incontinence. Bivariate analyses were carried out to assess the prevalence of fecal incontinence and sociodemographic characteristics, comorbidities, cognition, functional capacity, depression, frailty, quality of life, and falls. Logistic regression analysis was also performed, with fecal incontinence as the dependent variable. Results: Overall, 6855 subjects were evaluated; 66.56% were female, 52.93% white, and the mean age was 73.51 years. The prevalence of fecal incontinence was 5.93%. It was associated with worse self-care (OR 1.78 [1.08–2.96]), dependence for basic activities of daily living (OR 1.29 [1.01–1.95]), and urinary incontinence (OR 4.22 [3.28–5.41]). Furthermore, the absence of polypharmacy was identified as a protective factor (OR 0.61 [0.44–0.85]). Conclusion: The overall prevalence of fecal incontinence was 5.93%. On logistic regression, one quality of life variable, dependence for basic activities of daily living, and polypharmacy were significantly associated with fecal incontinence.

Frequency of Voiding and Defecation Dysfunction in Primary School Children in Zahedan, Southeast Iran

Background: Childhood voiding and defecation dysfunction are common problems in children of all ages worldwide. The prevalence of bowel and bladder dysfunction in children is reported to be approximately 47%. Objectives: Due to the different ethnic and socio-cultural characteristics, this study was conducted to investigate the frequency of voiding and defecation dysfunction in primary school children. In this study, we examined the urinary and defecation problems of patients and their relationship with each other. Methods: This cross-sectional descriptive-analytical study was performed on 400 children aged 7 to 13 years in Zahedan in 2016. Data were collected through a questionnaire. Finally, data were analyzed using SPSS 16 version. Statistical analysis was performed using descriptive and analytical statistics of the chi-square test. P-values less than 0.05 were considered statistically significant. Results: In this study, 400 students with a mean age of 9.96 ± 2.07 were studied, of whom 188 (47.1%) were girls and 212 (52.9%) were boys. The prevalence of urinary incontinence was 56.9%, 63.7% of whom were girls, and 36.3% were boys. The difference in the prevalence of urinary incontinence between girls and boys was large and statistically significant (P = 0.04). The prevalence of fecal incontinence was 61.7% among girls and 62.4% among boys (the total prevalence was 62.4% [239 cases]), but the difference in prevalence between girls and boys was small and statistically insignificant (P = 0.83). Conclusions: The prevalence of defecation dysfunction in school-age children was much higher than in previous studies. This may be due to differences in cultural and geographical environments. Due to the high prevalence of defecation dysfunction in children, it is recommended to have more focus on public education on various types of urinary and fecal dysfunction in urban and rural communities.

Characteristics of Fecal Incontinence in Male Patients in Japan.

Although community studies have shown no difference between the sexes in the prevalence of fecal incontinence (FI), few direct comparisons of disease characteristics between male and female patients have been reported. The aim of this study was to determine whether characteristics of FI differ between male and female patients in Japan. Included in the study were 408 (149 men, 259 women) patients with FI who visited the Matsushima Hospital Coloproctology Center between October 2016 and September 2017. We retrospectively evaluated data on age, number of bowel movements, Bristol stool form scale, number of FI, incontinence scores, anorectal manometry, comorbidities, and history of anal surgery. Maximum resting pressure and maximum squeeze pressure were found to be within normal range in significantly more male than female patients (34.9% vs. 12.4%, respectively; p < 0.0001). Irritable bowel syndrome (IBS, 20.1% vs. 9.3%; p = 0.003) and a history of anal surgery (29.5% vs. 17.5%; p = 0.02) were more prevalent among male patients than among female patients. Use of mepenzolate as treatment was significantly more common among male patients than among female patients (16.8% vs. 6.6%, respectively; p = 0.005). Responses to the various treatments were good, regardless of sex. FI appears to be more commonly accompanied by normal anal sphincter pressures in male patients than in female patients, and IBS and previous anal surgery appear to be more common among male patients than among female patients. FI appears to be controllable in most patients, regardless of sex.

Prevalence of pelvic floor dysfunction and sexual dysfunction in cervical cancer survivors: a systematic review and meta-analysis.

Pelvic floor dysfunction (PFD) and female sexual dysfunction (FSD) are symptoms that affect the quality of life of patients with cervical cancer (CC) after treatment. Our purpose was to estimate the prevalence of urinary incontinence (UI) and fecal incontinence (FI) associated with PFD and prevalence of FSD in CC patients. We searched PubMed, Embase, and the Cochrane Library from database inception to 31 January 2021 and selected articles assessing UI, FI and FSD in women with CC. Observational studies were included if they investigated UI, FI, and FSD. We included 14 of the 1,233 studies: 7 investigated FSD, 9 UI, and 3 FI. The results were highly heterogeneous because of the different populations and treatment methods. The prevalence of FSD, UI, and FI in CC patients after treatment was 45.0% (95% CI, 21.8-68.3%), 34.1% (95% CI, 25.5-42.7%), and 11.1% (95% CI, 4.8-17.3%). The results showed that different countries were the source of high heterogeneity of UI and FI (P<0.001). In this meta-analysis, the prevalence of PFD and FSD was high. These results are important for drawing attention to PFD and its early prevention and rehabilitation.

The effect of biofeedback pelvic floor training with ACTICORE1 on fecal incontinence A prospective multicentric cohort pilot study

IntroductionFecal incontinence refers to the inability to pass stool in a localized and timely manner resulting in the involuntary loss of intestinal contents such as air, intestinal mucus or stool. The prevalence of fecal incontinence in the general population is approximately 2–21%. Women are more frequently affected than men. Physiotherapeutically guided pelvic floor training, otherwise known as Kegel exercise, is the mainstay of treatment for fecal incontinence. The objective of this study was to evaluate the feasibility and potential benefits of a new biofeedback training, which uses a non-insertable pelvic floor sensor with digital interface, called ACTICORE1. MethodsFrom January 2020 to April 2021, we conducted a prospective non-randomized multicentric clinical pilot study at the Alexianer St. Hedwig Hospital Berlin (Germany), private clinic Strack (Germany) and the University Hospital Magdeburg (Germany). Patients with fecal incontinence, defined as a Wexner score >2, were recruited and asked to either perform biofeedback training with ACTICORE1 (6 min daily for 16 weeks) or daily Kegel exercise (Physiotherapeutic guidance weekly for the first 6 weeks; biweekly for the remaining 10 weeks). The primary outcome was severity of fecal incontinence after 16 weeks of training assessed using the Wexner score. Secondary outcomes were severity of fecal incontinence after 12 weeks and patients’ quality of life assessed using the EQ-5D-3L questionnaire after 16 weeks of training. The two-one-sided t-tests (TOST) procedure was used to determine if training with ACTICORE1 has equivalent or noninferior efficacies compared to Kegel exercise. ResultsA total of 40 individuals were included. Dropout occurred in 4 cases. The final sample included 19 patients who performed the ACTICORE1 training (ACTICORE-group) and 17 patients who performed guideline-based physiotherapy (PHYSIO-group). Univariate analysis of biometric parameters showed no statistically significant differences. Individuals in the ACTICORE-group were younger (M=46,6 (SD=18,9) years vs. M=57,1 (SD=17,3) years, p=0.093). In terms of endpoint evaluation, a non-inferiority of ACTICORE1 compared to the therapy standard (Kegel exercise) was detected. Both groups showed a statistically significant intraindividual improvement in fecal incontinence as measured by Wexner scoring after 16 weeks. The TOST detected a non-inferiority of ACTICORE1 training (98% confidence interval with equivalence bounds 5 for low and high; Results: 1.36, upper 6.75). ConclusionPelvic floor training with ACTICORE1 may enable sufficient pelvic floor training as a digital health application. The study at hand revealed a non-inferiority of ACTICORE1 training compared to Kegel exercise.

P474 Prevalence of fecal incontinence and clinical characteristics of IBD patients in remission and treated with biologics – experience from a tertiary referral center

Abstract Background Fecal incontinence (FI) is a debilitating disorder highly prevalent in inflammatory bowel disease (IBD) patients with reports in literature ranging from 20–80%. There is limited data on FI prevalence in IBD patients who are in remission, treated with biologics and their clinical characteristics. Methods In this cross-sectional observational study we have included IBD patients in remission, treated with biologics. Demographics and medical data were collected from electronic medical charts while patients were screened for FI using the St. Mark’s incontinence score (SMIS). Significant FI was characterized as SMIS ³6. Descriptive statistical analysis was used. Results We included 57 patients (24 female/33 male) in clinical remission treated with biologics, median age 41 years (18–70), 23 patients had ulcerative colitis (UC) and 34 had Crohn’s disease (CD). Median disease duration was 8 years (1–31). Significant FI was identified in 41 patient (71.9%) out of which 87.8% were in biochemical and 34.1% in endoscopical remission. FI was more prevalent among CD patients (76.4%) compared to UC (65.2%), but the difference did not reach statistical significance. FI was not significantly correlated to gender, type or number of biologics but there was significant positive correlation with disease duration (r=0.3139; p&amp;lt;0.05), especially for patients with disease duration longer than 5 years who had significantly higher mean SMIS score (9.1±4.6 vs 5.2±2.6; t-2.86; p&amp;lt;0.05). Furthermore, patients older than 50 years of age also had significantly higher average SMIS scores compared to younger patients (10.6±4.6 vs 7.6±4.3;t-2.09;p&amp;lt;0.05) Conclusion FI is highly prevalent in IBD patients treated with biologics, even in those who have reached endoscopical remission. Clinicians should be aware of this disorder and use available screening tools especially in older patients with longer disease duration in order to further improve quality of life of these patients.