Menopause and obstetric history as risk factors for fecal incontinence in women

Abstract

Background: Fecal incontinence is a highly prevalent condition, especially in women. However, few data on prevalence in women attending primary care are available, particularly regarding the presence of risk factors.

Objective: The aim of this study was to determine characteristics of women with fecal incontinence and to analyze obstetric history and menopause as potential risk factors.

Design: Observational study with a cross-sectional design.

Settings: Patients in primary care at 10 health care centers in Barcelona, Spain.

Main outcome measures: Fecal incontinence was defined as loss of flatus or liquid/solid stool occurring at least monthly. Data on the following variables were collected by face-to-face interviews and patient questionnaires: demographic and clinical characteristics, obstetric history, menopause data, fecal incontinence, and quality of life. Univariable and multivariable analyses were performed to study the association of potential risk factors with fecal incontinence.

Results: The study included 332 women with a mean age of 60.8 (SD, 17.8) years. The prevalence of fecal incontinence was 12.0% (40/332). Flatus incontinence was reported in 27 patients (67.5%), liquid stool incontinence in 25 (62.5%), and solid stool incontinence in (19) 47.5%. On multivariable analysis, the only independent risk factors for fecal incontinence were an obstetric history of complicated deliveries (instrumentation or podalic presentation; OR, 3.66; 95% CI, 1.54-8.68, P = .003) and menopause (OR, 5.67; 95% CI, 1.35-23.78; P = .018).

Limitations: The cross-sectional design hampered identification of the time at which the impact of menopausal status occurred, and data obtained from patient interviews was subject to recall bias.

Conclusions: Complicated deliveries are risk factors for fecal incontinence in women. Fecal incontinence appears to be more prevalent in menopausal women.