title: Faecal incontinence: an unrecognised epidemic in rural North Queensland? Results of a hospital-based outpatient study.
abstract: OBJECTIVE
  We explored the prevalence of faecal incontinence (FI) in a referral hospital outpatient population, to explore suspicions that FI is inadequately studied, underestimated and poorly appreciated in the rural North Queensland (NQ) community.
  
  
  METHODS
  Prospective cross-sectional study using a specifically designed questionnaire.
  
  
  METHODS
  The Townsville Hospital, a referral centre serving rural NQ.
  
  
  METHODS
  A total of 435 consecutive patients attending the gynaecology (n = 261) and colorectal clinics (n = 174) between 31 January and 12 June 2003 were enrolled (participating proportion 96.5%).
  
  
  METHODS
  FI prevalence, severity, impact on patients' lives, and risk factors.
  
  
  RESULTS
  The prevalence of FI in the study population (median age 53 years) was 20.7%. Amongst affected patients (n = 90) the median duration of FI was 2 years with more than half of those affected soiling themselves at least once a month. Many patients with FI (42%) reported feeling hopeless at least some of the time. Rectal prolapse, chronic constipation, psychiatric problems, colon disease, and urinary incontinence were all significantly associated with FI. A CART analysis revealed that many patients (45%) with urinary incontinence and chronic constipation also experienced FI.
  
  
  CONCLUSIONS
  This FI prevalence in a clinical setting in NQ is, apart from nursing home studies, the highest reported in the literature. FI negatively impacted on affected persons' lives. In patients presenting with urinary incontinence and chronic constipation, physicians should specifically enquire whether FI is also present. Definitive community studies to determine the scale of this 'silent epidemic' in northern Australia are now required.
authors.affiliation: School of Medicine and School of Public Health and Tropical Medicine, James Cook University, Townsville, Australia. yikhong.ho@jcu.edu.au
authors.forename: Yik-Hong
authors.initials: YH
authors.lastname: Ho
authors.forename: Reinhold
authors.initials: R
authors.lastname: Muller
authors.forename: Craig
authors.initials: C
authors.lastname: Veitch
authors.forename: Ajay
authors.initials: A
authors.lastname: Rane
authors.forename: David
authors.initials: D
authors.lastname: Durrheim
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003108:Colonic Diseases / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D014549:Urinary Incontinence / Q000453:epidemiology