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Prevalence of anal incontinence among Norwegian women: a cross-sectional study.

Rømmen K, Schei B, Rydning A, H Sultan A, Mørkved S - BMJ Open (2012)

Bottom Line: Anal incontinence (AI) is a symptom associated with age, bowel symptoms and obstetric injuries.Strongest associated symptoms are urgency and diarrhoea.The study was approved by the Regional Committee for Medical and Health Research Ethics (No. 2009/1214) and followed the Declaration of Helsinki.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.

ABSTRACT

Objective: Anal incontinence (AI) is a symptom associated with age, bowel symptoms and obstetric injuries. Primary aim of the study was to establish the prevalence of AI among women and secondarily to evaluate the impact on daily life and conditions associated with AI.

Design: A cross-sectional study.

Setting: Participants attended research stations located in different parts of Nord-Trøndelag county, Norway. Data were collected through interviews, questionnaires and clinical examinations.

Participants: In total, 40 955 community-dwelling women aged 30 years and older were invited. A total of 25 037 women participated, giving a participation rate of 61.1%.

Primary and secondary outcome measures: Fecal incontinence and flatal incontinence was defined as involuntary loss of feces and flatus weekly or more, respectively. AI was defined as the involuntary loss of feces and/or flatus weekly or more. Urgency was defined as the inability to defer defecation for 15 min. Statistical methods included prevalence estimates and logistic regression analysis.

Results: Questions about AI were completed by 20 391 (82.4%) women. Among the 20 391 women, AI was reported by 19.1% (95% CI 18.6% to 19.7%) and fecal incontinence was reported by 3.0% (95% CI 2.8% to 3.2%). Urgency was experienced by 2586 women (12.7%, 95% CI 12.2 to 13.1). Impact on daily life was stated by 794 (26.0%, 95% CI 24.4 to 27.5) women with AI. In bivariate age-adjusted analysis of AI, OR and CI for urgency (OR 3.19, 95% CI 2.92 to 3.49) and diarrhoea (OR 3.81, 95% CI 3.32 to 4.38) revealed strongest associations with AI.

Conclusions: AI affects one in five women older than 30 years. Strongest associated symptoms are urgency and diarrhoea.

Trial registration number: The study was approved by the Regional Committee for Medical and Health Research Ethics (No. 2009/1214) and followed the Declaration of Helsinki.

No MeSH data available.


Related in: MedlinePlus

Questions about anal incontinence applied in HUNT 3.
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Related In: Results  -  Collection

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fig2: Questions about anal incontinence applied in HUNT 3.

Mentions: Questionnaire 2 (Q2), which was age and gender specific, was given to the participantswhen attending. The participants could choose to fill in and return Q2 at the screeningstation or to fill in at home and return the questionnaire by postal mail. In Q2, theinstrument assessing AI was introduced as one of many different health-related topicsfor women in age categories 30–69 and 70+ years (figure 2). The women were asked to indicate whetherthey experienced involuntary leakage weekly or daily. We defined FI as experiencinginvoluntary leakage of any stool weekly or more often during the last month.Furthermore, women experiencing involuntary leakage of gas weekly or more often duringthe last month were considered to have flatal incontinence. AI wasdefined as reporting fecal and/or flatal incontinence weekly or more often during thelast month. Women reporting that the incontinence had an impact on their daily lifeweekly or more often were recognised as having bothersome incontinence. We definedurgency as the inability to defer defecation for 15 min.Women answering ‘no’ to the question ‘Are you able to deferdefecation and toilet visit for 15 min after first feeling the need togo?’ were categorised as having urgency. Data abouturinary incontinence were collected by asking the women ‘Do you experienceinvoluntarily leakage of urine?’. Women answering ‘yes’ tothis question were asked to indicate ‘How often do you experience urinaryleakage?’ with the following alternatives: less than once a month/morethan once a month/once a week or more/each day and/or night. Women reporting urinaryleakage weekly or more often were considered incontinent to urine. Information aboutpelvic surgery treatments and menopause was obtained with the questions: ‘Haveyou ever received surgical treatment for pelvic organ prolapse?’ and‘Have you ever had surgery treatment to remove the entire uterus?’.Responders answering ‘no’ and ‘I do not know’ and missingresponders were defined as to not having these conditions. Menopausal women wereidentified as the women answering the section about menopause. There was an independentinstrument measuring several bowel symptoms. The questions addressing diarrhoea,constipation and mixed diarrhoea and constipation were: ‘to which degree have youexperienced…diarrhoea/constipation/mixed diarrhoea and constipation … thelast 12 months?’. Frequency categories were never/some/a lot. Thosewho reported a lot of diarrhoea and/or constipation during the past 12 months werecategorised as experiencing diarrhoea and/or constipation, respectively.


Prevalence of anal incontinence among Norwegian women: a cross-sectional study.

Rømmen K, Schei B, Rydning A, H Sultan A, Mørkved S - BMJ Open (2012)

Questions about anal incontinence applied in HUNT 3.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4400729&req=5

fig2: Questions about anal incontinence applied in HUNT 3.
Mentions: Questionnaire 2 (Q2), which was age and gender specific, was given to the participantswhen attending. The participants could choose to fill in and return Q2 at the screeningstation or to fill in at home and return the questionnaire by postal mail. In Q2, theinstrument assessing AI was introduced as one of many different health-related topicsfor women in age categories 30–69 and 70+ years (figure 2). The women were asked to indicate whetherthey experienced involuntary leakage weekly or daily. We defined FI as experiencinginvoluntary leakage of any stool weekly or more often during the last month.Furthermore, women experiencing involuntary leakage of gas weekly or more often duringthe last month were considered to have flatal incontinence. AI wasdefined as reporting fecal and/or flatal incontinence weekly or more often during thelast month. Women reporting that the incontinence had an impact on their daily lifeweekly or more often were recognised as having bothersome incontinence. We definedurgency as the inability to defer defecation for 15 min.Women answering ‘no’ to the question ‘Are you able to deferdefecation and toilet visit for 15 min after first feeling the need togo?’ were categorised as having urgency. Data abouturinary incontinence were collected by asking the women ‘Do you experienceinvoluntarily leakage of urine?’. Women answering ‘yes’ tothis question were asked to indicate ‘How often do you experience urinaryleakage?’ with the following alternatives: less than once a month/morethan once a month/once a week or more/each day and/or night. Women reporting urinaryleakage weekly or more often were considered incontinent to urine. Information aboutpelvic surgery treatments and menopause was obtained with the questions: ‘Haveyou ever received surgical treatment for pelvic organ prolapse?’ and‘Have you ever had surgery treatment to remove the entire uterus?’.Responders answering ‘no’ and ‘I do not know’ and missingresponders were defined as to not having these conditions. Menopausal women wereidentified as the women answering the section about menopause. There was an independentinstrument measuring several bowel symptoms. The questions addressing diarrhoea,constipation and mixed diarrhoea and constipation were: ‘to which degree have youexperienced…diarrhoea/constipation/mixed diarrhoea and constipation … thelast 12 months?’. Frequency categories were never/some/a lot. Thosewho reported a lot of diarrhoea and/or constipation during the past 12 months werecategorised as experiencing diarrhoea and/or constipation, respectively.

Bottom Line: Anal incontinence (AI) is a symptom associated with age, bowel symptoms and obstetric injuries.Strongest associated symptoms are urgency and diarrhoea.The study was approved by the Regional Committee for Medical and Health Research Ethics (No. 2009/1214) and followed the Declaration of Helsinki.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.

ABSTRACT

Objective: Anal incontinence (AI) is a symptom associated with age, bowel symptoms and obstetric injuries. Primary aim of the study was to establish the prevalence of AI among women and secondarily to evaluate the impact on daily life and conditions associated with AI.

Design: A cross-sectional study.

Setting: Participants attended research stations located in different parts of Nord-Trøndelag county, Norway. Data were collected through interviews, questionnaires and clinical examinations.

Participants: In total, 40 955 community-dwelling women aged 30 years and older were invited. A total of 25 037 women participated, giving a participation rate of 61.1%.

Primary and secondary outcome measures: Fecal incontinence and flatal incontinence was defined as involuntary loss of feces and flatus weekly or more, respectively. AI was defined as the involuntary loss of feces and/or flatus weekly or more. Urgency was defined as the inability to defer defecation for 15 min. Statistical methods included prevalence estimates and logistic regression analysis.

Results: Questions about AI were completed by 20 391 (82.4%) women. Among the 20 391 women, AI was reported by 19.1% (95% CI 18.6% to 19.7%) and fecal incontinence was reported by 3.0% (95% CI 2.8% to 3.2%). Urgency was experienced by 2586 women (12.7%, 95% CI 12.2 to 13.1). Impact on daily life was stated by 794 (26.0%, 95% CI 24.4 to 27.5) women with AI. In bivariate age-adjusted analysis of AI, OR and CI for urgency (OR 3.19, 95% CI 2.92 to 3.49) and diarrhoea (OR 3.81, 95% CI 3.32 to 4.38) revealed strongest associations with AI.

Conclusions: AI affects one in five women older than 30 years. Strongest associated symptoms are urgency and diarrhoea.

Trial registration number: The study was approved by the Regional Committee for Medical and Health Research Ethics (No. 2009/1214) and followed the Declaration of Helsinki.

No MeSH data available.


Related in: MedlinePlus