Missed Opportunities: A Mixed-Methods Assessment of Disparities in Treatment for Fecal Incontinence

Area of Science:

• Urogynecology and Pelvic Health
• Health Disparities Research
• Patient-Reported Outcomes

Background:

• Previous research indicates racial disparities in accessing fecal incontinence (FI) treatments.
• Patient perspectives on barriers to FI treatment remain under-explored.

Purpose of the Study:

• To assess differences in FI symptom severity and treatment utilization between Black and White patients.
• To understand patient experiences with FI treatments and identify racial disparities.

Main Methods:

• A mixed-methods approach was used, combining retrospective data with structured interviews.
• The study included adult non-Hispanic Black and White women with FI who had suboptimal responses to initial medical therapy.
• Interviews focused on treatments offered, symptom severity, and daily functioning impact.

Main Results:

• Black patients reported significantly higher rates of occasional, weekly, or daily solid, stool, and flatal incontinence compared to White patients.
• Black patients were less likely to experience symptom improvement or adhere to prescribed fiber supplements and antidiarrheal medications.
• Black patients reported greater daily functioning impairment due to FI and a higher desire for sacral neuromodulation follow-up.

Conclusions:

• Black patients experience more severe FI symptoms and less favorable treatment outcomes.
• Racial differences in patient preferences and experiences must be addressed in FI management strategies.
• Further research is needed to develop culturally sensitive and effective FI treatment approaches for diverse populations.