Fecal incontinence in US adults: epidemiology and risk factors.
Level 4 - case-series / case-control
Cross-sectional population survey (NHANES)
PubMed 19410574 · doi:10.1053/j.gastro.2009.04.054
What was done
Analyzed data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) including 4,308 civilian, noninstitutionalized US adults aged 20 or older (2,229 women and 2,079 men). Fecal incontinence (FI) was assessed using the validated Fecal Incontinence Severity Index and defined as accidental leakage of solid, liquid, or mucus at least once in the preceding month. Sampling weights were applied to estimate national population prevalence, and multivariate logistic regression identified independent risk factors.
What was found
The estimated overall prevalence of FI in noninstitutionalized US adults was 8.3% (95% CI, 7.1-9.5%), comprising liquid stool in 6.2%, mucus in 3.1%, and solid stool in 1.6%. Weekly or more frequent FI occurred in 2.7%. Prevalence was 8.9% in women and 7.7% in men, increasing with age from 2.6% (ages 20-29) to 15.3% (ages 70 and older). No significant associations were found with race/ethnicity, education, income, or marital status after adjusting for age. Independent risk factors for women were advancing age, loose or watery stools, more than 21 stools per week, multiple chronic illnesses, and urinary incontinence. Independent risk factors for men were advancing age, loose or watery stools, poor self-rated health, and urinary incontinence.
Why it matters
This study establishes reliable national prevalence estimates for fecal incontinence across sexes and age groups in the US adult population. It highlights chronic diarrhea and stool consistency as primary modifiable targets for prevention and clinical management.
Limits
The cross-sectional design precludes establishing causal relationships. Institutionalized individuals, such as nursing home residents who typically have higher rates of incontinence, were excluded, likely underestimating total burden. Assessment relied entirely on self-report over a one-month recall period.
Cited by
- supports Approximately 7% of Americans experience fecal incontinence.