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Risk factors in acquired faecal incontinence
Peter J Lunniss1, Marc A Gladman, Franc H Hetzer
1Centre for Academic Surgery, Gastrointestinal Physiology Unit, Queen Mary's School of Medicine and Dentistry, Royal London Hospital, Whitechapel, London E1 1BB, UK.
Journal of the Royal Society of Medicine
|March 5, 2004
Summary
Childbirth complications and anal surgery are key causes of fecal incontinence in adults. Occult damage to the continence mechanism can lead to symptoms years later, impacting quality of life.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Urogynecology
Background:
- Acquired fecal incontinence is a prevalent and debilitating condition affecting the non-elderly population.
- Identifying specific risk factors is crucial for understanding and managing this condition.
Purpose of the Study:
- To determine the relative importance of individual risk factors in the development of fecal incontinence.
- To correlate risk factors with abnormal results on anorectal physiological testing.
Main Methods:
- Retrospective cohort analysis of 629 patients referred to a tertiary center.
- Identification and analysis of potential risk factors for fecal incontinence.
- Assessment of anorectal physiological testing results.
Main Results:
- Childbirth complications (91%) were the primary risk factor in women, often involving perineal injury or forceps delivery.
- Anal surgery was the main risk factor in 59% of men.
- Abnormalities in anorectal physiology were detected in 76% of men and 96% of women.
- A significant delay between precipitating events and symptom onset was noted in many cases.
Conclusions:
- Vaginal delivery complications and anal surgery are significant contributors to fecal incontinence.
- Occult damage to the continence mechanism can manifest years after the initial event.
- Early identification and management of risk factors are essential for improving patient outcomes.