Prevalence and Associated Factors of Fecal Incontinence: A Global Population-Based Study

The global prevalence of fecal incontinence (FI) is likely underestimated with an unmet need to identify associated factors to improve patient care. This study aimed to report the global prevalence of FI and to identify associated factors.

Data from the internet survey of the cross-sectional Rome Foundation Global Epidemiology Study, including 26 countries, were used. The prevalence of any FI, defined as any accidental leakage of stool during the last 3 months, and the prevalence of Rome IV FI were evaluated. The association between other bowel and anorectal symptoms and FI was assessed using individual items of the Rome IV diagnostic questionnaire.

Any FI was reported in 13.8% and Rome IV FI in 1.6%. The prevalence of any FI ranged from 10.9% in Eastern Europe to 19.7% in North America, and Rome IV FI from 0.8% in the Middle East to 3.3% in North America. The prevalence of any FI was higher in males, the elderly, and the obese, with similar patterns in Rome IV FI, except for no sex difference. In multivariable analyses, all bowel and anorectal symptoms were associated with having any FI and Rome IV FI, with urgency, loose stools, and abdominal and rectal pain showing the strongest links. Both any FI and Rome IV FI were associated with a lower quality of life.

FI is common across the globe, but with regional differences. Strong associations with abdominal and rectal pain, as well as diarrhea- and constipation-specific symptoms, suggest a role of both altered stool consistency and visceral hypersensitivity in FI pathophysiology.