Fecal Incontinence in US Adults: Epidemiology and Risk Factors
W.E. Whitehead, L. Borrud, P.S. Goode, S. Meikle, E. Mueller, A. Tuteja, et al.
BACKGROUND & AIMS The study aims were to estimate the prevalence of different types and frequencies of fecal incontinence (FI), describe demographic factors, and identify risk factors. METHODS The National Health and Nutrition Examination Survey (NHANES) assesses health status in the civilian non-institutionalized U.S. population. The validated Fecal Incontinence Severity Index was added to NHANES in 2005-2006. Participants were 2,229 women and 2,079 men aged 20 or older. FI was defined as accidental leakage of solid, liquid or mucus at least once in the preceding month. Sampling weights were used to obtain prevalence estimates for the national population. Multivariate logistic regression identified independent risk factors. RESULTS The estimated prevalence of FI in non-institutionalized U.S. adults is 8.3% (CI 7.1, 9.5) and consists of liquid stool in 6.2%, solid stool in 1.6%, and mucus in 3.1%. It occurs at least weekly in 2.7%. Prevalence is similar in women (8.9%) and men (7.7%), and increases with age from 2.6% in 20-29 year-olds up to 15.3% in participants aged 70 and over. FI is not significantly associated with race/ethnicity, education, income, or marital status after adjusting for age. Independent risk factors in women are advancing age, loose or watery stools, more than 21 stools per week, multiple chronic illnesses, and urinary incontinence. Independent risk factors in men are age, loose or watery stools, poor self-rated health, and urinary incontinence. CONCLUSIONS FI is a prevalent, age-related disorder. Chronic diarrhea is a strong modifiable risk factor, which may form the basis for prevention and treatment.
Gastroenterology. Aug 2009; 137(2): 512–517.e2. Published online May 4, 2009. doi: 10.1053/j.gastro.2009.04.054