Relation of bowel habits to fecal incontinence in women.
BACKGROUND
Though most women with fecal incontinence (FI) have anorectal dysfunctions, a majority have intermittent symptoms. Variations in bowel habits and daily routine may partly explain this.


OBJECTIVE
To compare bowel habits and daily routine between controls and FI, and between continent and incontinent stools among women with FI.


METHODS
Using a mailed questionnaire, we identified 507 women with FI among 5,300 women in Olmsted County, MN. Bowel habits were compared among 127 randomly selected controls and 154 women with self-reported FI, who did ("active" FI, N = 106) or did not ("inactive" FI, N = 48) have an incontinent episode during a 2-wk bowel diary period.


RESULTS
Independent risk factors for FI were: rectal urgency (odds ratio [OR] for inactive FI vs controls 5.6, 95% confidence interval [CI] 2.3-13.3; and OR for active FI vs inactive FI 2.0, 95% CI 0.9-4.3) and a sense of incomplete evacuation (OR for inactive FI vs controls 3.5, 95% CI 1.4-8.8; and OR for active FI vs inactive FI 2.2, 95% CI 1.1-4.9). Similar results were found for stool frequency and form. Among incontinent women, incontinent stools (versus continent stools) were less formed, more likely to occur at work, and to be preceded by rectal urgency.


CONCLUSIONS
Bowel patterns, rectal urgency, and daily routine influence the occurrence of FI. Stool characteristics explained 46% of the likelihood for incontinence episodes, emphasizing that anorectal sensorimotor dysfunctions must also contribute to FI in women.
Bharucha
Adil E
AE
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Seide
Barbara M
BM
Zinsmeister
Alan R
AR
Melton
L Joseph
LJ
D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000502:physiology*; D003672:Defecation / Q000502:physiology*; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D005247:Feeding Behavior; D005260:Female; D006184:Habits; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors