Perry S, Shaw C, McGrother C, Matthews R J, Assassa R P, Dallosso H, Williams K, Brittain K R, Azam U, Clarke M, Jagger C, Mayne C, Castleden C M
Department of Epidemiology and Public Health, University of Leicester, Leicester, UK.
Gut. 2002 Apr;50(4):480-4. doi: 10.1136/gut.50.4.480.
Prevalence studies of faecal incontinence in the general population are rare and the impact of faecal incontinence on quality of life has not been previously addressed.
To establish the prevalence of faecal incontinence in adults in terms of frequency of leakage, degree of soiling, and level of impact on quality of life.
In a cross sectional postal survey, 15 904 adults aged 40 years or more (excluding residents of nursing and residential homes) were selected randomly by household from the Leicestershire Health Authority patient register. Participants were asked to complete a confidential health questionnaire. Major faecal incontinence was defined as soiling of underwear or worse with a frequency of several times a month or more. Respondents were also asked if bowel symptoms had an impact on their quality of life.
From a total sample of 10 116 respondents, 1.4% reported major faecal incontinence and 0.7% major faecal incontinence with bowel symptoms that had an impact on quality of life. Major faecal incontinence was significantly associated with a lot of impact on quality of life (odds ratio 12.4, 95% confidence interval 7.5-20.6). Incontinence was more prevalent and more severe in older people but there was no significant difference between men and women.
This study has confirmed that faecal incontinence is a fairly common symptom, particularly in older people. Faecal incontinence in men has received little attention in the past and the results from this study indicate that it is as much of a problem in men as it is in women while the level of unmet need in this group is high. Estimates of need for health care for this symptom should be multidimensional and assess both the severity of symptoms and the impact it has on quality of life.
普通人群中大便失禁的患病率研究较少,且此前尚未探讨大便失禁对生活质量的影响。
根据漏便频率、弄脏程度以及对生活质量的影响程度,确定成人大便失禁的患病率。
在一项横断面邮寄调查中,从莱斯特郡卫生局患者登记册中按家庭随机选取15904名40岁及以上的成年人(不包括养老院和疗养院居民)。参与者被要求填写一份保密的健康问卷。重度大便失禁定义为每月数次或更频繁地弄脏内衣或更严重的情况。还询问了受访者肠道症状是否对其生活质量有影响。
在10116名受访者的总样本中,1.4%报告有重度大便失禁,0.7%有重度大便失禁且肠道症状对生活质量有影响。重度大便失禁与对生活质量有很大影响显著相关(优势比12.4,95%置信区间7.5 - 20.6)。失禁在老年人中更普遍且更严重,但男女之间无显著差异。
本研究证实大便失禁是一种相当常见的症状,尤其是在老年人中。男性大便失禁过去很少受到关注,本研究结果表明,男性的这一问题与女性一样严重,且该群体未满足的需求水平很高。对该症状的医疗需求评估应是多维度的,既要评估症状的严重程度,也要评估其对生活质量的影响。