Walter Susanna, Hjortswang Henrik, Holmgren Katarina, Hallböök Olof
Institution of Clinical and Experimental Medicine (IKE), Division of Gastroenterology, Linköping University, Sweden.
Scand J Gastroenterol. 2011 Jan;46(1):6-12. doi: 10.3109/00365521.2010.513059. Epub 2010 Aug 24.
The association between abdominal symptoms, disease severity of fecal incontinence (FI), and quality of life (QoL) is not yet clear. We hypothesized that it would become clearer by prospective diary data. We also aimed to compare QoL of FI patients with ulcerative colitis (UC) patients in relapse and remission.
Sixty-five consecutive female patients with FI recorded bowel symptoms prospectively on diary cards. QoL was evaluated with the disease specific short health scale questionnaire (SHS). Patients with UC in remission and relapse were used as a reference group regarding SHS.
FI patients had median 3.5 leakage episodes/week. In all, 48% of bowel movements were associated with urgency. Urgency was correlated to decreased QoL according to SHS domains: symptoms (Rho = 0.54, p = 0.0002), function (Rho = 0.48, p = 0.0008), and disease related worry (Rho = 0.32, p = 0.027). Abdominal pain and bloating, reported by nearly half of patients, correlated to deceased QoL but not to number of leakages. QoL of patients with FI compared to UC in active phase (n = 35) was similar. FI patients had decreased QoL compared to UC in remission (n = 94) in all dimensions of SHS: symptoms (p < 0.0001), function (p < 0.0001), disease related worry (p < 0.0001), and general well being (p = 0.03).
Urgency and irritable bowel syndrome (IBS)-like symptoms were associated with decreased QoL in FI. Therefore, IBS should be considered as an important confounding factor in FI QoL studies. QoL in patients with FI was considerably decreased, in a similar extent as in patients with UC in relapse.
腹部症状、粪失禁（FI）的疾病严重程度与生活质量（QoL）之间的关联尚不清楚。我们推测通过前瞻性日记数据会使其更加明晰。我们还旨在比较FI患者与处于复发和缓解期的溃疡性结肠炎（UC）患者的生活质量。
65例连续的女性FI患者前瞻性地在日记卡上记录肠道症状。使用疾病特异性简短健康量表问卷（SHS）评估生活质量。处于缓解期和复发期的UC患者用作SHS的参照组。
FI患者每周漏粪发作次数的中位数为3.5次。总体而言，48%的排便伴有急迫感。根据SHS各领域，急迫感与生活质量下降相关：症状（Rho = 0.54，p = 0.0002）、功能（Rho = 0.48，p = 0.0008）以及疾病相关担忧（Rho = 0.32，p = 0.027）。近一半患者报告的腹痛和腹胀与生活质量下降相关，但与漏粪次数无关。与活动期UC患者（n = 35）相比，FI患者的生活质量相似。与缓解期UC患者（n = 94）相比，FI患者在SHS的所有维度上生活质量均下降：症状（p < 0.0001）、功能（p < 0.0001）、疾病相关担忧（p < 0.0001）以及总体健康状况（p = 0.03）。
急迫感和肠易激综合征（IBS）样症状与FI患者生活质量下降相关。因此，在FI生活质量研究中应将IBS视为一个重要的混杂因素。FI患者的生活质量显著下降，程度与复发期UC患者相似。
