Hosmer Amy E, Saini Sameer D, Menees Stacy B
1 Division of Gastroenterology, Department of Internal Medicine, Ohio State University, Columbus, OH, USA.
Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
J Neurogastroenterol Motil. 2019 Oct 30;25(4):576-588. doi: 10.5056/jnm17134.
BACKGROUND/AIMS: Fecal incontinence (FI) is a common complaint that increases in prevalence with age. Our aim was to determine the prevalence of FI and assess its severity by self-report in a male-predominant Veteran outpatient clinic setting.
An anonymous 28 item questionnaire was administered to a convenience sample of veterans awaiting appointments. FI was defined as a loss of liquid or solid stool at least monthly. Multivariable logistic and linear models were used to identify predictors of FI prevalence and severity.
One hundred thirty-three gastroenterology (GI) participants and 126 primary care (PC) participants completed the survey. Ninety-four of 259 participants (36.3%, 95% confidence interval [CI]: 30.4-42.5) reported an episode of FI (41.4% GI participants vs 31.0% PC participants; = 0.078) with 33.6% having FI within the last 30 days (36.8% GI participants vs 30.2% PC participants; = 0.122). Participants with more bowel movements per week ( = 0.005) and per day ( < 0.001) and with a higher Bristol Stool Scale form ( = 0.010) were more likely to have FI. Of participants with FI, mean Fecal Incontinence Severity Index score was 23.0 ± 9.5 with a significantly higher symptom score in GI participants compared to PC participants (25.2 ± 10.0 vs 20.1 ± 8.2; = 0.011). Few participants had ever been asked by (35.0%) or evaluated by (18.0%) a doctor for FI symptoms.
FI is a common complaint and under-recognized problem in the male-dominant Veteran population. Despite its prevalence, relatively few participants were asked about FI, with even less being treated. Due to the possible effects and implications on quality of life, more should be done to recognize this condition and arrange treatment.
背景/目的：大便失禁（FI）是一种常见疾病，其患病率随年龄增长而升高。我们的目的是确定在以男性为主的退伍军人门诊环境中，通过自我报告得出的FI患病率，并评估其严重程度。
对等待预约的退伍军人便利样本进行了一项包含28个条目的匿名问卷调查。FI被定义为至少每月出现一次液体或固体粪便失禁。使用多变量逻辑回归和线性模型来确定FI患病率和严重程度的预测因素。
133名胃肠病学（GI）参与者和126名初级保健（PC）参与者完成了调查。259名参与者中有94名（36.3%，95%置信区间[CI]：30.4 - 42.5）报告有过FI发作（41.4%的GI参与者 vs 31.0%的PC参与者；P = 0.078），其中33.6%在过去30天内有FI（36.8%的GI参与者 vs 30.2%的PC参与者；P = 0.122）。每周排便次数更多（P = 0.005）、每天排便次数更多（P < 0.001）以及布里斯托大便分类法（Bristol Stool Scale）形态更高（P = 0.010）的参与者更有可能出现FI。在有FI的参与者中，大便失禁严重程度指数（Fecal Incontinence Severity Index）平均得分为23.0 ± 9.5，GI参与者的症状评分显著高于PC参与者（25.2 ± 10.0 vs 20.1 ± 8.2；P = 0.011）。很少有参与者曾被医生询问过（35.0%）或评估过（18.0%）FI症状。
在以男性为主的退伍军人人群中，FI是一种常见且未得到充分认识的问题。尽管其患病率较高，但相对较少的参与者被询问过FI情况，接受治疗的更少。鉴于其对生活质量可能产生的影响，应采取更多措施来识别这种情况并安排治疗。
