Evaluation and Treatment of Fecal Incontinence

摘要

Fecal incontinence, defined by the involuntary leakage of stool, flatus, or mucus, is a debilitating pelvic floor disorder that greatly decreases patient quality of life. Women are less likely to report symptoms to their health care providers given the embarrassing and socially isolating nature of the condition. Lack of standardization in definition and grading scale of incontinence severity, in combination with patient underreporting, means that prevalence is not well established. In most recent estimates, the prevalence of fecal incontinence in noninstitutionalized women ranges from 2% to 22%. The National Health and Nutrition Examination Survey estimated the prevalence of fecal incontinence as 2.9% to 21.6% in a study of more than 2000 adults age 20 to 80 years. Similarly, an analysis of the Nurses' Health Study showed a prevalence of 9% to 17% in more than 64,000 women in their sixth to eighth decades of life. White women are twice as likely to experience fecal incontinence as black women, and women with urinary incontinence and/or pelvic organ prolapse are more likely to have symptoms of fecal incontinence as well.