title: Impact of high-level sport practice on anal incontinence in a healthy young female population.
abstract: BACKGROUND
  Regular physical activity usually confers health benefits, but high-level sport may induce harmful outcomes, such as pelvic floor dysfunction. Urinary incontinence (UI) was previously documented, but few data are available about anal incontinence (AI) in female athletes. Our aim was to determine the role of high-level sport practice on AI in a young, healthy female population.
  
  
  METHODS
  In this cross-sectional study, we included women aged 18-40 years. Self-administered questionnaires were delivered to each female volunteer. Two groups were defined: (1) intensive sport (IS) group: high-level sport (>8 hours weekly), and (2) nonintensive sport (NIS) group: all other subjects.
  
  
  RESULTS
  Of the 393 women enrolled, 169 were in the IS group and 224 were in the NIS group. Women of the IS group were significantly younger than the others (21.74±4.28 vs. 24.87±5.61 years, p<0.001) and had less births (0.07±0.31 vs. 0.20±0.62, p=0.005). The prevalence of AI was statistically higher in the IS group than in the NIS group (14.8% vs. 4.9%, p=0.001), as was UI (33.1% vs. 18.3%, p=0.001). Multivariate analysis showed that IS practice (odds ratio [OR] 2.99, 95% confidence interval [CI] 1.29-6.87, p=0.010) and body mass index (BMI) (OR 1.14, 95% CI 1.01-1.28, p=0.033) were significantly linked to AI when taking into account major confounding factors (age and births). In the IS group, AI was mainly represented by loss of flatus in 84%.
  
  
  CONCLUSIONS
  High-level sport appears to be a significant independent risk factor for AI in healthy young women. These results suggest that preventive measures, such as pelvic floor muscle training, may be proposed for this young population.
authors.affiliation: Department of Gastroenterology, Nord University Hospital, Université de la Méditerranée, Marseille, France. vittonv@yahoo.com
authors.forename: Véronique
authors.initials: V
authors.lastname: Vitton
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck-Barrau
authors.forename: Sarah
authors.initials: S
authors.lastname: Brardjanian
authors.forename: Isabelle
authors.initials: I
authors.lastname: Caballe
authors.forename: Michel
authors.initials: M
authors.lastname: Bouvier
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Grimaud
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes / Q000145:classification; D003248:Constipation / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004414:Dyspareunia / Q000453:epidemiology; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D017773:Pelvic Floor / Q000503:physiopathology; D012307:Risk Factors; D013177:Sports; D013334:Students; D011795:Surveys and Questionnaires; D014495:Universities; D014549:Urinary Incontinence / Q000453:epidemiology; D055815:Young Adult