It's not a topic that would be discussed in polite company, but that doesn't mean it isn't a significant problem for a growing number of women. A new study has found that fecal incontinence (FI) is prevalent among women in older age groups, those who have had numerous babies, women whose deliveries were assisted by forceps or vacuum devices, and those who have had a hysterectomy. Interestingly, many women in the study who had FI also had another medical condition - such as major depression or diabetes - and often experienced urinary incontinence as well as FI. The researchers believe that FI could be a contributing factor to depression in some cases, and depression could be a contributing factor to FI in other cases.
"Increased attention should be paid to this debilitating condition, especially considering the aging of our population and the available treatments for FI," said study author Dee E. Fenner, at the University of Michigan Medical School. "It is very important to the health of women that clinicians are aware of the prevalence of FI and can treat their patients accordingly."
The study, reported in the American Journal of Obstetrics and Gynecology, surveyed 6,000 women aged between 30 and 90. Of the women who responded, the prevalence of FI was found to be 7 percent, with the occurrence increasing notably with age. In the survey, FI was defined as loss of liquid or solid stool at least monthly. The impact of incontinence on the quality of life of the respondents was "significant," said Fenner. "We found that half of the subjects with FI reported that their bowel symptoms had a large impact on their quality of life."
Damage to the anal sphincter muscles or scarring to the rectum, causing it to be unable to hold stool, was one of the major reasons cited by the researchers for FI. Ulcerative colitis and Crohn's disease can cause this scarring to occur. Another contributing factor can be the stretching of the nerves that supply the sphincters, called the pudendal nerves, which can occur with childbirth, old age or trauma. Without intact nerves to stimulate the sphincters, the sphincters may undergo atrophy. The researchers said it was important for women to be aware of the conditions that often go along with FI. These include:
- A higher number of deliveries
- Urinary incontinence
- A previous hysterectomy
- Another medical condition as well, such as major depression or diabetes
- A history of operative vaginal delivery, such as those using forceps or a vacuum-assisted device.
The researchers added that while FI is present in many elderly women, it should not be considered merely a normal part of aging. Treatments that can help people manage FI can range from changes in diet and exercise, to medications that improve the formation of stools, to surgery that repairs the sphincter muscles. In some cases, an artificial bowel sphincter can be implanted under the skin to mimic the natural function of the anal sphincter.
Source: University of Michigan Health System
