Faecal incontinence - how many people experience this problem?

Dr Sarah Perry of the Leicestershire MRC Incontinence Study gives the findings of their latest research.

Faecal incontinence must be one of the most embarrassing problems to experience, yet very little is known about how many people are affected or the impact it has on them. The Leicestershire MRC Incontinence Study recently presented some findings that shed some light on these issues*. A confidential postal questionnaire was sent to a random sample of 15,904 adults aged 40 years or more living in Leicestershire and Rutland. The questionnaire included questions on general health, urinary and bowel symptoms and quality of life issues. The specific questions on faecal incontinence looked at three areas: how frequently people leaked faeces, the extent of soiling, and the impact of these symptoms on lifestyle.

We defined ‘major faecal incontinence’ as leakage from the bowels several times a month and soiling of underwear or worse. ‘Minor incontinence’ is leakage several times a month and staining of underwear. People were asked how much their bowel problems affected them, including their daily activities, social life, relationships and sleep patterns. ‘Disabling incontinence’ was classified as major incontinence with a big impact on quality of life. We also asked if people needed help with symptoms.

The response to the questionnaire was good - 70% of adults returned the questionnaire. Response rates were slightly lower in men and in younger adults. In total, 1.7% reported minor faecal incontinence, 1.4% major incontinence, 0.7% disabling incontinence. Less that half a percent said they wanted help with symptoms.

Incontinence was more common and more severe in older people. Faecal incontinence was more common in certain groups of people. Older people, people with long-term illness, people with mobility problems, and people with urinary incontinence all had more faecal problems. Sex and ethnic group were not associated with the prevalence of faecal incontinence.

The study has shown that faecal incontinence is a fairly common symptom, in men as well as women. Over 3% of all the people in the study had some faecal incontinence. It is an even bigger difficulty for older people with long-term health and mobility problems. However, less than half of those with major faecal incontinence say that it has a big impact on their life. Even fewer say they need help.

Some people may have learnt to manage their symptoms on their own. Perhaps they believe it is something they must put up with rather than seek help for. Promotion of continence in primary care settings could prevent disability in later life, so we need to look into how to prevent these problems, or treat them before they become severe.

* This work is a summary of a paper presented at a conference "Faecal incontinence: advances and innovations" in London, April 2000 and has been submitted for publication.

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