Asthma and Chronic Obstructive Pulmonary Disease Are Associated with an Increased Risk of Developing Fecal...

Fecal incontinence (FI) is a common condition associated with aging. Asthma and chronic obstructive pulmonary disease (COPD) are obstructive lung diseases associated with both urinary incontinence and increased intraabdominal pressures.

We sought to evaluate whether these obstructive lung diseases increase the risk of developing FI.

We prospectively examined the association between asthma, COPD and asthma/COPD overlap and risk of FI among women from the Nurses' Health Study (NHS). We defined incident FI as ≥ 1 liquid or solid FI episode/month during four years of follow-up using self-administered, biennial questionnaires (2008-2012). Validated self-report of asthma and COPD were used from 1988 to 2008. We used Cox proportional hazards models to calculate multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for FI risk associated with obstructive lung diseases.

We documented 6,091 cases of incident FI in the asthma cohort (n = 54,444, with asthma 6,100, without asthma 48,344). Compared to women without asthma, the aHR for FI in those with asthma was 1.18 (95%CI 1.09-1.27). We documented 5,834 cases of incident FI in the COPD cohort (n = 51,837, with COPD 3,484, without COPD 48,353). Compared to women without COPD, the aHR for FI in those with COPD was 1.16 (95%CI 1.05-1.27). We documented 5,773 cases of incident FI in the asthma/COPD cohort (n = 51,156, with asthma/COPD overlap 2,803, without 48,353). Compared to women without asthma/COPD overlap, the aHR for FI in those with asthma/COPD overlap was 1.28 (95%CI 1.16-1.42).

Asthma and COPD are associated with increased risk of developing FI. Further studies are needed to elucidate the pathophysiology driving this association.