title: Factors associated with fecal incontinence in a nationally representative sample of diabetic women.
abstract: OBJECTIVE
  Fecal incontinence (FI) is a debilitating condition that significantly affects quality of life, and has been associated with multiple risk factors. Our goal was to assess the prevalence of FI among diabetic women and evaluate factors associated with FI in this population.
  
  
  METHODS
  The National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010 was used to evaluate women with diabetes mellitus and FI. FI was defined as involuntary loss of mucus, liquid, or solid stool at least monthly. Severity was evaluated using the Fecal Incontinence Severity Index. Potential risk factors associated with FI were explored with weighted chi-squared statistics. Variables associated with FI in multivariable logistic regression analysis are reported with odds ratios (OR) and 95 % confidence intervals (95 % CI).
  
  
  RESULTS
  Among 7,039 women, 13.6 % were diabetic, and 18.1 % of diabetic women reported FI compared to 8.4 % in the overall NHANES population (p < .001). In diabetic women, FI was associated with advancing age (OR 1.3, 95 % CI 1.1 - 1.5), depression (OR 2.0 95 % CI 0.9 - 4.5), poorer health status (OR 1.9, 95 % CI 1.2 - 3.1), urinary incontinence (OR 3.5, 95 % CI 2.1 - 5.9) and bowel movement frequency of ≥21/week (OR 4.9, 95 % CI 2.3 - 10.6) in a multivariable logistic regression model adjusted for race, education level, BMI, comorbidities, prior hysterectomy, and stool consistency.
  
  
  CONCLUSIONS
  FI affects one in five diabetic women and is strongly associated with high bowel movement frequency, a possible important modifiable factor that should be investigated further in prospective studies.
authors.affiliation: Division of Urogynecology, Department of Ob/Gyn, University of North Carolina at Chapel Hill, CB#7570, 3032 Old Clinics Building, Chapel Hill, NC, 27599-7570, USA. nieto.luzm@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: De La Luz Nieto
authors.affiliation: Division of Urogynecology, Department of Ob/Gyn, University of North Carolina at Chapel Hill, CB#7570, 3032 Old Clinics Building, Chapel Hill, NC, 27599-7570, USA.|Center for Women's Health Research, Center for Aging and Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
authors.affiliation: Division of Urogynecology, Department of Ob/Gyn, University of North Carolina at Chapel Hill, CB#7570, 3032 Old Clinics Building, Chapel Hill, NC, 27599-7570, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Matthews
authors.affiliation: Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
authors.affiliation: Birmingham VAMC GRECC, Birmingham, AL, USA.|Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Alayne D
authors.initials: AD
authors.lastname: Markland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Diabetes; Fecal incontinence; Health status; Urinary incontinence