| 1. |
- Simrén, Magnus, 1966, et al.
(author)
-
Fecal incontinence in irritable bowel syndrome: Prevalence and associated factors in Swedish and American patients
- 2017
-
In: Neurogastroenterology and Motility. - : Wiley. - 1350-1925. ; 29:2
-
Journal article (peer-reviewed)abstract
- BackgroundFecal incontinence (FI) is a prevalent but poorly recognized problem in the general population with profound negative effects on daily life. The prevalence of FI in irritable bowel syndrome (IBS) and its association with clinical, demographic, and pathophysiological factors remain largely unknown. MethodsOne US (n=304) and one Swedish (n=168) patient cohort fulfilling Rome III criteria for IBS completed Rome III diagnostic questions on FI and IBS symptoms, and questionnaires on IBS symptom severity, quality of life, anxiety and depression, and work productivity impairment. The patients also underwent assessments of colorectal sensitivity and motility. Key ResultsFecal incontinence one day per month was reported by 19.7% (USA) and 13.7% (Sweden) of IBS patients. These proportions rose to 43.4% and 29.8% if patients with less frequent FI were included. Fecal incontinence prevalence was higher in older age groups, with a clear increase above age 40. Irritable bowel syndrome patients with FI reported greater overall IBS symptom severity, more frequent and loose stools, and greater urgency. Negative effects of FI on quality of life, psychological distress, and work productivity were demonstrated. No associations were found between colorectal physiology and FI. Conclusions & InferencesFecal incontinence is common in IBS patients, and similar to previous general population reports, the major risk factors for FI in IBS are older age, rectal urgency, and loose, frequent stools. When IBS patients have comorbid FI, the impact on quality of life, psychological symptoms, and work impairment appears greater.
|
|
| 2. |
|
|
| 3. |
- Heymen, S., et al.
(author)
-
Patient preferences for endpoints in fecal incontinence treatment studies
- 2017
-
In: Neurogastroenterology and Motility. - : Wiley. - 1350-1925. ; 29:5
-
Journal article (peer-reviewed)abstract
- Background: Randomized controlled trials of treatments for fecal incontinence (FI) are difficult to compare because case definitions and study endpoints vary. Our aims were to assess patient perspectives on the case definition for FI and how treatment success should be measured. Methods: In Phase 1, 28 FI patients participated in anonymous on-line focus groups, and in Phase 2, 186 people with FI, stratified by gender, race, and age completed an online survey. Key Results: Focus group participants described frequency and urgency as the most important characteristics for defining FI. Most (80%) thought staining of underwear constitutes FI, but only 33% thought gas leakage was FI. When asked how the success of treatment should be defined, 77% said by a reduction in frequency or complete cure, but less than half thought a 50% reduction in frequency was enough. When asked how much reduction would be needed, responses averaged 80%. The Phase 2 survey confirmed that frequency, urgency, and intestinal discomfort are the most important characteristics for case definition, and that success should be defined by at least a 75% decrease in frequency. A 50% reduction was an acceptable endpoint for 58% overall but only 26% for those aged 65. Adequate relief was acceptable to 78%. Conclusions and Inferences: Inclusion criteria for trials should specify a minimum frequency of FI. Most patients would require a 75% reduction in FI frequency to call a treatment successful but young adults and those with more severe FI would accept a 50% reduction as meaningful.
|
|
