Outcomes of combination treatment of fecal incontinence in women.
OBJECTIVE
To describe how women with fecal incontinence (FI) respond to combined pharmacologic therapy and pelvic floor muscle exercises (PFME).


METHODS
Validated questionnaires (Fecal Incontinence Severity Index and Modified Manchester Health Questionnaire) were mailed to 80 women who received combined therapy for FI and had complete baseline assessments. Regression models were constructed to identify predictors of change in questionnaire scores.


RESULTS
Response rate was 69%. Mean age was 59 +/- 12 years. All women were taught PFME with digital palpation, and 87% of the women received medications. FI severity scores and quality-of-life (QOL) improved from baseline to follow-up (P < .001 and P = .02, respectively). A fair/normal external anal sphincter (EAS) contraction resulted in greater improvements in FI severity (13 points, P = .006) and QOL scores (22 points, P < .001).


CONCLUSIONS
FI severity and QOL improved after combination therapies, and a fair/normal EAS contraction predicted greater improvement.
Markland
Alayne D
AD
Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Richter
Holly E
HE
Burgio
Kathryn L
KL
Wheeler
Thomas L
TL
Redden
David T
DT
Goode
Patricia S
PS
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015444:Exercise; D005242:Fecal Incontinence / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D016014:Linear Models; D008139:Loperamide / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D017773:Pelvic Floor; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D008139:Loperamide