title: Determining levels of fecal incontinence in the community: a New Zealand cross-sectional study.
abstract: BACKGROUND
  Fecal incontinence is a socially stigmatized condition, and its prevalence in the community has been problematic to quantify because of difficulty with its definition.
  
  
  OBJECTIVE
  This study estimates the community prevalence of fecal incontinence in New Zealand by 3 scales of measurement: patient perceptions of a "problem with bowel control," their symptoms, and their quality of life. DESIGN/MAIN OUTCOME MEASURES: A postal survey of 2000 people, aged >18, randomly selected from the national electoral roll, was performed. This used a validated, reliability-tested, anonymous questionnaire, the Comprehensive Fecal Incontinence Questionnaire, incorporating the identification of a "problem with bowel control," the Fecal Incontinence Severity Index, and the Fecal Incontinence Quality of Life Scale.
  
  
  RESULTS
  The response rate was 68.7%. A total of 14.7% (95% CI: 12.6-16.7) of participants "felt they had a problem with bowel control" and 12.4% (95% CI: 10.5-14.5) had fecal incontinence when defined using the Fecal Incontinence Severity Index table as "leakage of liquid or solid stool ≥ 1/month." In terms of quality of life, 26.8% of the population (95% CI: 24.2-29.4) noted some impairment on the Fecal Incontinence Quality of Life Scale. In total, 155 (13.2%) participants reported at least 2 of the 3 possible diagnostic measures, and this may provide a way to incorporate the 3 measures into a new definition of fecal incontinence.
  
  
  CONCLUSIONS
  This study incorporated a new "generic" question enquiring about an individual's perception of a bowel control problem and also introduced a "cutoff" value for Fecal Incontinence Quality of Life Scale to attempt to identify those with any impairment "due to accidental bowel leakage."
  
  
  CONCLUSIONS
  This study helps to highlight some of the challenges involved with suitably identifying those who have fecal incontinence within the community. The prevalence rate of 13.2% represents a realistic measure of the burden of fecal incontinence in the general population, and further research in this area is recommended.
authors: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors: A
authors: A
authors: Sharma
authors: R J
authors: RJ
authors: Marshall
authors: A K
authors: AK
authors: Macmillan
authors: A E H
authors: AE
authors: Merrie
authors: P
authors: P
authors: Reid
authors: I P
authors: IP
authors: Bissett
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012647:Self-Assessment; D012720:Severity of Illness Index