title: Symptoms and quality of life in community women with fecal incontinence.
abstract: OBJECTIVE
  Assessments of symptom severity are necessary to guide therapy in fecal incontinence (FI). However, there is no consensus on how self-reported symptom severity in FI should be measured for this purpose, and the relationship between symptoms of FI and its impact on quality of life (QOL) is not known.
  
  
  METHODS
  A questionnaire was mailed to an age-stratified random sample of 5300 women identified through the Rochester Epidemiology Project. Symptom severity was assessed by a validated scale (Fecal Incontinence and Constipation Assessment [FICA]), and impact on 15 domains of QOL was evaluated for subjects who had any FI during the past year. The scale incorporated the type, frequency, and amount of FI, as well as the circumstances surrounding FI (ie, urge or passive FI). A QOL-weighted symptom severity score was derived by weighting the responses for these characteristics, in each subject, by the average QOL impact for all subjects who reported that specific symptom characteristic. The relationship between symptom severity and the QOL-weighted symptom severity score was assessed by Spearman rank correlation.
  
  
  RESULTS
  Altogether, 2800 of 5300 (53%) women responded to the survey. FI symptoms were mild (45%), moderate (50%), or severe (5%). Among women with FI, the FICA symptom severity scale was strongly correlated (r(s) = 0.92, P < .0001) with the QOL-weighted symptom severity score.
  
  
  CONCLUSIONS
  Among unselected women in the community, self-reported symptom severity, rated by the FICA scale, was strongly correlated with the impact of FI on QOL, supporting the use of this scale to assess symptom severity in FI.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. bharucha.adil@mayo.edu
authors.forename: Adil E
authors.initials: AE
authors.lastname: Bharucha
authors.forename: Alan R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: G Richard
authors.initials: GR
authors.lastname: Locke
authors.forename: Cathy
authors.initials: C
authors.lastname: Schleck
authors.forename: Kimberly
authors.initials: K
authors.lastname: McKeon
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Melton
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008910:Minnesota; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires