Varma Madhulika G, Brown Jeanette S, Creasman Jennifer M, Thom David H, Van Den Eeden Stephen K, Beattie Mary S, Subak Leslee L
Department of Surgery, University of California, San Francisco, San Francisco, California 94115, USA.
Dis Colon Rectum. 2006 Jun;49(6):841-51. doi: 10.1007/s10350-006-0535-0.
This study was designed to estimate the prevalence of, and identify risk factors associated with, fecal incontinence in racially diverse females older than aged 40 years.
The Reproductive Risks for Incontinence Study at Kaiser is a population-based study of 2,109 randomly selected middle-aged and older females (average age, 56 years). Fecal incontinence, determined by self-report, was categorized by frequency. Females reported the level of bother of fecal incontinence and their general quality of life. Potential risk factors were assessed by self-report, interview, physical examination, and record review. Multivariate logistic regression analysis was used to determine the independent association between selected risk factors and the primary outcome of any reported fecal incontinence in the past year.
Fecal incontinence in the past year was reported by 24 percent of females (3.4 percent monthly, 1.9 percent weekly, and 0.2 percent daily). Greater frequency of fecal incontinence was associated with decreased quality of life (Medical Outcome Short Form-36 Mental Component Scale score, P = 0.01), and increased bother (P < 0.001) with 45 percent of females with fecal incontinence in the past year and 100 percent of females with daily fecal incontinence reporting moderate or great bother. In multivariate analysis, the prevalence of fecal incontinence in the past year increased significantly [odds ratio per 5 kg/m2 (95 percent confidence interval)] with obesity [1.2 (1.1-1.3)], chronic obstructive pulmonary disease [1.9 (1.3-2.9)], irritable bowel syndrome [2.4 (1.7-3.4)], urinary incontinence [2.1 (1.7-2.6)], and colectomy [1.9 (1.1-3.1)]. Latina females were less likely to report fecal incontinence than white females [0.6 (0.4-0.9)].
Fecal incontinence, a common problem for females, is associated with substantial adverse affects on quality of life. Several of the identified risk factors are preventable or modifiable, and may direct future research in fecal incontinence therapy.
本研究旨在评估40岁以上不同种族女性大便失禁的患病率，并确定与之相关的风险因素。
凯撒医疗集团的失禁生殖风险研究是一项基于人群的研究，随机选取了2109名中老年女性（平均年龄56岁）。通过自我报告确定大便失禁情况，并按频率进行分类。女性报告大便失禁的困扰程度及其总体生活质量。通过自我报告、访谈、体格检查和记录审查评估潜在风险因素。采用多因素逻辑回归分析来确定所选风险因素与过去一年中任何报告的大便失禁这一主要结局之间的独立关联。
24%的女性报告过去一年有大便失禁（每月3.4%，每周1.9%，每天0.2%）。大便失禁频率越高，生活质量下降越明显（医学结局简明36项量表精神健康分量表评分，P = 0.01），困扰程度增加越明显（P < 0.001），过去一年有大便失禁的女性中有45%，每天有大便失禁的女性中有100%报告有中度或重度困扰。在多因素分析中，过去一年大便失禁的患病率随着肥胖[每5 kg/m2的比值比（95%置信区间）为1.2（1.1 - 1.3）]、慢性阻塞性肺疾病[1.9（1.3 - 2.9）]、肠易激综合征[2.4（1.7 - 3.4）]、尿失禁[2.1（1.7 - 2.6）]和结肠切除术[1.9（1.1 - 3.1）]而显著增加。拉丁裔女性报告大便失禁的可能性低于白人女性[0.6（0.4 - 0.9）]。
大便失禁是女性常见问题，对生活质量有重大负面影响。一些已确定的风险因素是可预防或可改变的，可能为未来大便失禁治疗的研究指明方向。
