Prevalence Of Fecal Incontinence Research Articles

S824 Prevalence of Fecal Incontinence and Quality of Life in the General Population Versus Patients With IBS

S824 Prevalence of Fecal Incontinence and Quality of Life in the General Population Versus Patients With IBS

FP1.14 - A Re-audit of the prevalence of faecal incontinence in hospital inpatients

Abstract Introduction Faecal incontinence (FI) is a common and under-reported problem, with many patients too embarrassed to seek help. Patients often do not receive optimal care due to lack of identification. In-hospital identification when they are admitted for other reasons may be one method of improving the care of such patients. Aims & Methods We had assessed the identification of continence problems in our hospital inpatients via a simple ‘spot check’ audit of the different wards in 2015; we used the case notes for checking the documentation by both nursing and medical staff. We looked at care plans, stool charts, follow up plans etc. We repeated this audit in 2023 to check for any improvement. Results Overall,132 (163 in 2015) patient case notes were examined. 94%(previously 90) had nursing documentation about bowels documented in comparison to 47% (48) for medical documentation. 5.3% (10.8) were found to have FI. Only 28% (31) of these patients would have been identified by medical documentation. Most of the patients identified with FI were elderly, as expected; surprisingly, 28.57% were on general surgical wards. All patients (100%) in 2015 were then referred appropriately for further management. In 2023, though some action for FI was taken in 71.42 % patients, no referral was apparently arranged in any. Conclusion It is important to identify patients with FI, establish cause and initiate appropriate management. The impact on the individual patient’s QOL needs assessment prior to planning management/specialist referral etc. We found that our nursing documentation was still better than medical documentation which needs to be improved; however, onward referral/management needs improving significantly.

Effect of Single-Dose Imipramine on Anal Sphincter Tone in Healthy Women: A Randomized, Placebo-Controlled Study Using Anal Acoustic Reflectometry

Introduction and HypothesisDespite the high prevalence of fecal incontinence, existing treatment options may be inadequate. Drugs that enhance the tone of the anal sphincter complex could potentially be an effective pharmacological approach. This study investigated the effect of the tricyclic antidepressant imipramine on anal sphincter tone in healthy women, employing anal acoustic reflectometry as the evaluating method.MethodsIn a double-blind, randomized, placebo-controlled crossover study, 16 healthy female volunteers were randomized to one of two treatment sequences. The participants attended two study visits separated by at least 7 days’ washout. At each visit, they received a single dose of 50 mg imipramine or matching placebo, in alternating order. We assessed the anal opening pressure under the resting state and during voluntary squeezing of the pelvic floor. Measurements were performed pre-dose and 1 h after drug administration, corresponding to the estimated time of peak plasma concentration of imipramine.ResultsAll participants completed the study. In total, 44% of the participants reported at least one adverse effect, primarily anticholinergic. Compared with placebo, imipramine increased anal opening pressure by 15.2 cmH2O (95% confidence interval [CI] 2.0–28.2 cmH2O, p = 0.03) in the resting state and 15.1 (95% CI 4.2–26.0 cmH2O, p = 0.01) cmH2O during squeezing.ConclusionsThe findings indicate that imipramine increases anal sphincter tone in healthy women. However, further research is required to evaluate its clinical impact on individuals with fecal incontinence. This research also demonstrates the effectiveness of using anal acoustic reflectometry for assessing pharmacological effects on anal sphincter function.

Prevalence of faecal incontinence in patients with inflammatory bowel disease: Severity and its relationship with quality of life.

To describe the prevalence of faecal incontinence in patients with inflammatory bowel disease, assess its severity, and correlation with quality of life. We adhered to relevant EQUATOR guidelines, STROBE method. Correlational-descriptive study. Hebrew-speaking patients seen at an inflammatory bowel disease clinic in a large tertiary medical center in Jerusalem between February 2020 and December 2020 completed the Faecal Incontinence Severity Index and the Faecal Incontinence Quality of Life Scale. Ninety-six patients participated in the study, of which 70 (72.9%) had Crohn's disease, and 26 (27.1%) had ulcerative colitis. Eighty-five (88.5%) reported faecal incontinence with an overall Faecal Incontinence Severity Index mean of 27.66 (SD 15.99), yet only 14 (14.7%) reported that their physician or nurse inquired about faecal incontinence. Quality of life scores for patients with faecal incontinence was the lowest on the coping/behaviour scale (M = 2.44; SD 0.94) and the highest on the depression/self-perception scale (M = 2.86; SD 1.04). Significant correlations were found between faecal incontinence severity and quality of life in all scales except for self-embarrassment. Moderate correlations in the same scales were noted in patients with Ulcerative Colitis, while no significant correlations were found in the Crohn's Disease group. A high proportion of inflammatory bowel disease patients reported faecal incontinence associated with impaired quality of life. Only a few were questioned about faecal incontinence by their physician or nurse. There is limited literature regarding the prevalence and severity of faecal incontinence in inflammatory bowel disease patients. A high proportion of patients reported faecal incontinence, which negatively correlated with quality of life. Physicians and nurses must inquire about faecal incontinence to improve patient care. No patient or public contribution.

Epidemiology of Faecal Incontinence for People with Dementia Living in the Community in New Zealand: A Retrospective Cohort Study Using interRAI Home Care Assessment Data

Plain Language SummaryDementia is the largest single contributor to disability and need for care among older adults. Dementia is accompanied by a progressive decline in cognitive abilities that interferes with the performance of activities of daily living, including toileting. Caregivers rate the independent use of the toilet as the most important activity that they would like the person living with dementia to retain. Faecal incontinence affects the quality of life, causes caregiver strain and is often likely to contribute to moving the person with dementia into a care home. However, there are currently no robust estimates of how many people with dementia living in the community (not in a care home) also experience faecal incontinence. Using a national dataset (interRAI-HC) from New Zealand, we demonstrate that during 1 year (August 2020 to July 31, 2021) 26.7% of people living with dementia faced the additional challenge of faecal incontinence. Over a 5‐year period (August 2016 to July 2021) the risk of developing faecal incontinence for people living with dementia was 1.7 times greater than the risk for people without dementia. Our study demonstrates that faecal incontinence affects a significant proposal of older people with dementia who are living in the community in New Zealand. Globally, more than 35 countries collect the same data as used in this study. We argue, that this could be used internationally, to better understand the level of community, health and clinical services that are required to support people with dementia and their caregivers to manage faecal incontinence.

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 health care utilization. The impact of obesity on FI remains unclear, with differing conclusions using body mass index (BMI) as a 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 to 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 7606 participants were included, with an overall FI prevalence of 9.2%. When stratified by quartiles of body measurements, FI was increasingly prevalent from the 1st to the 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 with the 1st quartile of body measurements (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.11-2.80; P= .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 United States 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.