Impact of fecal incontinence on quality of life

Abstract

Aim: To explore the impact of fecal incontinence (FI) on quality of life (QOL) of patients attending urogynecology and colorectal clinics (CCs).

Methods: Cross-sectional study of 154 patients (27 male) with FI, who attended the clinics at a regional hospital in North Queensland, Australia in 2003 and 2004, and completed the Fecal Incontinence Quality of Life Scale (FIQL: 1 = very affected; 4 = not affected).

Results: More than 22% of patients had their QOL affected severely by FI. Patients reported that they had not previously been asked about FI by a medical practitioner nor did they voluntarily disclose its presence. The median FIQL scores for all participants were: lifestyle = 3.24; coping = 2.23; depression = 2.42; and embarrassment = 2.33. Increasing frequency of soiling had a negative effect on all four FIQL scales (P < 0.001) as did the quantity of soiling (P < 0.01). Female CC patients had poorer FIQL scores than urogynecology clinic patients for lifestyle (P = 0.015), coping (P = 0.004) and embarrassment (P = 0.009), but not depression (P = 0.062), despite having experienced FI for a shorter period.

Conclusion: Failure to seek treatment for FI degrades the quality of patients' lives over time. FI assessment tools should incorporate the quantity of fecal loss.

Figure 1

Association of FIQL scales with sex and CC and UC. FIQL, Rockwood et al[22]; Box and whisker demonstrates median, IQR, minimum and maximum. P values calculated by unpaired Wilcoxin test (Mann-Whitney); QOL score of 1 represents very low functional status and 4 is not affected by FI; FIQL scales calculated as per letter to the editor, Rockwood[26].