Bowel function among people 75+ reporting faecal incontinence in relation to help seeking, dependency and quality of life.
OBJECTIVE
The aim was to compare faecal incontinence and related bowel symptoms among men and women and being dependent or not (aged >or=75 years) and furthermore to identify which bowel symptoms predicted help seeking, dependency and low quality of life (QoL).


BACKGROUND
Faecal incontinence (FI) in old age is a common condition and influences daily life to a great extent, although few actually seek medical help.


METHODS
A total of 248 people with reported difficulties controlling faeces answered a postal questionnaire or were interviewed with questions about FI-related bowel symptoms. A factor analysis resulted in four areas of bowel symptoms and was used in logistic regression with help seeking, dependency and low QoL as dependent variables.


RESULTS
Of all the subjects, 56.4% had leakage, 54.7% did not reach the toilet in time, 55.6% had incomplete emptying, 27.9% had hard stool, 36.8% bother from moisture from the anus, 32.2% could not withstand urgency for five minutes and 17% had red skin or wounds in the genital region. Women and those dependent were most affected. Totally 40.8% had sought help and 30.1% used protective aids. Leakage, discomfort, consistency and contractibility symptoms were the categories of bowel symptoms related to FI. Discomfort predicted help seeking (OR 3.0), dependency (OR 1.5) and physical QoL (OR 1.7). Leakage predicted help seeking (OR 1.9) but not dependency and QoL.


CONCLUSIONS
Overall bowel function was disturbed among those with FI and unmet needs seem problematic especially for women and those needing help in Activities of Daily Living (ADL). Encouragement to seek and get medical help and to use protective aids may improve the very low quality of life in this group.


CONCLUSIONS
Older people with FI should be asked about, assessed for and examined for overall bowel function to get adequate treatment and be encouraged to use protection.
Stenzelius
Karin
K
Department of Health Sciences, Lund University and Department of Urology, University Hospital, Lund, Sweden.
Westergren
Albert
A
Hallberg
Ingalill R
IR
D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003248:Constipation / Q000209:etiology; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000209:etiology; D005163:Factor Analysis, Statistical; D005242:Fecal Incontinence / Q000150:complications / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D020380:Needs Assessment; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden