Incontinence: IFFGD Research Initiative Results in Prevalence Study

Anal incontinence, the loss of anal sphincter control, leads to the unwanted release of solid or liquid stool or gas. Even when it occurs only occasionally, anal incontinence can have catastrophic consequences on self-confidence, personal image, and the ability to integrate socially and in employment.

A lack of prevalence information means incomplete understanding of who is at greatest risk of suffering from anal incontinence and the undertaking of prevention.

Beginning in 1993, IFFGD launched a research project to determine the prevalence of and characteristics associated with anal incontinence in the general community. (The American Society of Colon and Rectal Surgeons Research Foundation assisted with a grant in support of the project.) The results of this research initiative were published in The Journal of the American Medical Association (JAMA), August 16, 1995, Volume 274.

In this survey anal incontinence was reported in 2.2% of the general population. Age, sex, physical limitations and poor general health are all risk factors. In past surveys, obstetrical injury in women is usually described as the primary risk factor. However, our survey and others have also shown a high prevalence of incontinence in men.

More studies of causes must be done. IFFGD encourages further research into specific health and activity related factors that may be associated with incontinence in the general population.

The following is the abstract of the referenced article

Community-Based Prevalence of Anal Incontinence
Richard Nelson, MD; Nancy Norton; Eleanor Cautley, MS; Sylvia Furner, PhD

Objective

To determine the prevalence of and characteristics associated with anal incontinence in the general community.

Setting

Community survey.

Participants

The population of the state of Wisconsin sampled in the Wisconsin Family Health Survey. Subjects were identified by random digit dialing with telephone interview. The individual within each household identified as most knowledgeable about the health status of all other members of the household was asked about the health status of each member of the household. Approximately 200 households were surveyed each month.

Main Outcome Measures

The presence of anal incontinence to solid or liquid feces or gas, who suffered from it, the frequency of anal incontinence, and how the incontinent person coped with it.

Results

A total of 2570 households comprising 6959 individuals were surveyed, and 153 individuals were reported to have anal incontinence, representing 2.2% of the population (95% confidence interval [CI], ±0.3%). Thirty percent of the incontinent subjects were older than 65 years, and 63% were women. Of those with anal incontinence, 36% were incontinent to solid feces, 54% to liquid feces, and 60% to gas. In a multivariate analysis, independent associations of the following risk factors with anal incontinence were found; female sex (odds ratio [OR], 1.5; CI, 1.1 to 2.1), age (continuously adjusted)(OR, 1.01:CI, 1.01 to 1.02), physical limitations (OR, 1.8; CI, 1.2 to 2.7), and poor general health (OR, 1.6; CI, 1.4 to 1.9).

Conclusions

Anal incontinence was reported in 2.2% of the general population. Independent risk factors for incontinence include female sex, advancing age, poor general health, and physical limitations.

(JAMA. 1995;274:559-561)