Racial differences in fecal incontinence in community-dwelling women from the EPI study

Despite its prevalence and associated distress, fecal incontinence (FI) is not well understood. There are limited data regarding associations between FI and race. The goal of this study was to estimate the prevalence of FI, and to secondarily identify demographic, lifestyle, and medical factors associated with FI, especially with regard to race.

This was a planned secondary analysis of a population-based cross-sectional telephone interview survey of 2812 black and white community-dwelling women living in southeastern Michigan. The primary outcome measured was the prevalence of self-reported FI, defined as any loss of stool during the previous 12 months. Logistic regression modeling was used to identify characteristics independently associated with FI.

Of the subjects, 16.7% reported FI in the previous year. Fecal incontinence was approximately twice as common in white women (20%) as black women (11%). Factors associated with FI differed between the 2 races, although its prevalence in both racial groups increases with higher numbers of medical comorbidities, increased frequency of bowel movements per week, and depression.

One in 6 women report FI, although it occurs one-half as often in black as in white women. Although there are common characteristics shared by women with FI in both racial groups, white women experience FI in complex with other pelvic floor disorders. For black women, FI is an isolated pelvic floor disorder associated with mobility impairment.