Faecal incontinence (FI) contributes to a substantial health burden and current rates of FI are under reported. Greater understanding of the prevalence and associated factors of faecal incontinence within communities will allow more efficient planning of health care resources. A recent review in Diseases of Colon and Rectum, Faecal Incontinence: Community Prevalence and Associated Factors—A Systematic Review explores the world literature to identify the community prevalence and associated risk factors for faecal incontinence.
An issue raised by the review is the lack of standard definition for faecal incontinence across studies. This raises the importance of a standard definitions regarding this disorder. The median prevalence of faecal incontinence appears to be 7.7% worldwide, but the variation in definition for incontinence contributes to significant variation of this number. Interestingly the higher quality studies reported a median prevalence of 11.2%.
The rate of faecal incontinence is reported as the same in males (median 8.1%) and females (median 8.9%). This may come as a surprise with many assuming the rate would be higher in females. Unsurprisingly the rate of faecal incontinence increases with age, 15 to 34 year old subjects have a 5.7% median prevalence rate of faecal incontinence. For those over 90 years of age there is a median rate of 15.9%. The other factors most commonly reported to be associated with faecal incontinence are diarrhoea and urinary incontinence. Another interesting finding was that along with constipation and hard stools, obstetric history or previous obstetric trauma was not associated with an increased faecal incontinence rate.
This review highlights, not only the significant prevalence of faecal incontinence in our patients, but also the large variation in terminology and definitions of faecal incontinence used by researchers. There is a clear need for standardised definitions and objective measures in the field of faecal incontinence.
Article by the Publication and Communications Committee
Dis Colon Rectum. 2015 Dec;58(12):1194-209. doi: 10.1097/DCR.0000000000000514.