Epidemiology of Fecal Incontinence

Fecal incontinence (FI), defined as the involuntary loss of solid or liquid feces can impact daily life and lead to social withdrawal. The prevalence of FI in the community increases with age, and depending on survey methods and definition of FI, varies from 2.2- 15%. Only a minority of women with FI disclose the symptom to a physician. Hence women with diarrhea should be asked about FI. Scales assessing severity of FI should incorporate type, frequency, and amount of leakage, and fecal urgency. FI is associated with increasing age, obesity, diarrhea, multiple chronic illnesses, and obstetric trauma. Obstetric anal sphincter injury can cause FI. However, among unselected women in the community, FI typically begins 2-3 decades after vaginal delivery; in this population, diarrhea and rectal urgency are the strongest independent risk factors and obstetric trauma is not. FI is not an independent risk factor for institutionalization or mortality.