Accidental bowel leakage in the mature women's health study: prevalence and predictors

Abstract

Background: The 2007 National Institutes of Health incontinence consensus panel emphasised the need for classification and identification of persons at risk for faecal incontinence (FI).

Objectives: To explore the prevalence of FI; to characterise severity and 'bother'; and to identify factors associated with FI in a large sample of community-dwelling women.

Design, setting, and participants: A cohort of US women ≥ 45 years old was surveyed via an internet-based questionnaire between September 2009 and April 2010.

Main outcome measure: Accidental leakage of liquid or solid stool at least once in the last 12 months.

Key results: Eighty-five per cent of those surveyed (5817/6873) participated and were predominantly white, well educated and insured. The prevalence of FI at least once in the past year was 18.8% (1096/5817; 95% CI: 17.8-19.9%) and 97% of these women were bothered by this frequency of leakage. Among 938 respondents with FI, 71.1% (667) preferred the term 'accidental bowel leakage' (ABL) over faecal or bowel incontinence. Bowel disorders, urinary incontinence, stroke, age 55-64, diabetes mellitus and prior vaginal delivery were associated with an increased odds of FI, whereas being married, Black or American Indian/Alaska Native race/ethnicity, and income ≥ $40,000 per year were associated with a decreased odds of FI.

Conclusions: Nearly one-fifth of mature US women suffer from bothersome leakage of stool at least yearly and the overwhelming majority prefer the term 'Accidental Bowel Leakage.' Those with bowel disorders and urinary incontinence are most likely to experience ABL. Incorporating questions regarding ABL or bowel and bladder disorders into routine screening may aid in identifying silent sufferers of ABL.