title: Defecation disorders: a French population survey.
abstract: OBJECTIVE
  Despite frequent occurrence, functional defecation disorders and related conditions have been infrequently reported in population studies. This study was designed to assess symptoms, lifestyle-behavioral changes, and medical care seeking related to functional defecation disorders in a large household community survey.
  
  
  METHODS
  A large household community survey was conducted in 10,000 individuals aged 15 years or older. A mailed questionnaire was used to assess ten common anorectal complaints; frequency, association, impact on quality of life, and medical care seeking were quantified.
  
  
  RESULTS
  Evaluation was obtained in 7,196 patients (3,455 males). During the previous 12-month period, 2,097 patients (29.1 percent) experienced functional defecation disorders: outlet constipation and fecal incontinence were reported in 22.4 and 16.8 percent respectively. Compared with patients with no anorectal complaint, patients with functional defecation disorders had a different gender status (females, 63.3 vs. 47.6 percent; P<0.01). Based on symptom severity, functional defecation disorders were perceived as the main anorectal complaint in 1,192 patients. In this group, emptying difficulties, unsatisfied defecation, gas, and fecal incontinence occurred at least once per month in 71.6, 56.1, 77.9, and 49 percent respectively: 66.6 percent with outlet constipation and 85.6 percent with incontinence revealed impairment in quality of life. Incontinent patients more frequently avoided medical care than those complaining of outlet constipation (67.4 vs. 46.4 percent; P<0.01).
  
  
  CONCLUSIONS
  Functional defecation disorders concerns at least one of four French individuals. Outlet constipation and fecal incontinence frequently occur in association. Despite a low rate of patients seeking care, symptoms often are severe and related to quality of life impairment.
authors.affiliation: Gastroenterology Unit, Centre Hospitalier Régionale & Universitaire de Pontchaillou, Rennes, France. laurent.siproudhis@chu-rennes.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Siproudhis
authors.forename: François
authors.initials: F
authors.lastname: Pigot
authors.forename: Philippe
authors.initials: P
authors.lastname: Godeberge
authors.forename: Henri
authors.initials: H
authors.lastname: Damon
authors.forename: Denis
authors.initials: D
authors.lastname: Soudan
authors.forename: Marc André
authors.initials: MA
authors.lastname: Bigard
mesh_terms: D000328:Adult; D000368:Aged; D003248:Constipation / Q000453:epidemiology*; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018571:Sentinel Surveillance; D011795:Surveys and Questionnaires