Prevalence of and Factors Associated With Fecal Incontinence: Results From a Population-Based Survey

Gastroenterology. 2018 May;154(6):1672-1681.e3. doi: 10.1053/j.gastro.2018.01.062. Epub 2018 Feb 3.


Background & aims: Fecal incontinence (FI) is characterized by uncontrolled passage of solid or liquid stool. We aimed to determine the prevalence and severity of FI in a large sample of US residents.

Methods: We recruited a representative sample of patients in October 2015 to complete the National Gastrointestinal (GI) Survey; a mobile app called MyGiHealth was used to systematically collect data on GI symptoms. FI was defined as accidental leakage of solid or liquid stool. Severity of FI was determined by responses to the National Institutes of Health FI Patient Reported Outcomes Measurement Information System questionnaire. Multivariable regression models were used to identify factors associated with FI prevalence and severity.

Results: Among 71,812 individuals who completed the National GI Survey, 14.4% reported FI in the past; of these, 33.3% had FI within the past 7 days. Older age, male sex, and Hispanic ethnicity increased the likelihood of having FI within the past week. Individuals with Crohn's disease, ulcerative colitis, celiac disease, irritable bowel syndrome, or diabetes were more likely to report FI. Non-Hispanic black and Hispanic individuals and individuals with Crohn's disease, celiac disease, diabetes, human immunodeficiency virus/acquired immunodeficiency syndrome, or chronic idiopathic constipation had more severe symptoms of FI than individuals without these features.

Conclusions: In a large population-based survey, 1 in 7 people reported previous FI. FI is age-related and more prevalent among individuals with inflammatory bowel disease, celiac disease, irritable bowel syndrome, or diabetes than people without these disorders. Proactive screening for FI among these groups is warranted.

Keywords: Epidemiology; IBS; Incidence; Risk Factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Fecal Incontinence / epidemiology*
  • Fecal Incontinence / etiology
  • Fecal Incontinence / pathology
  • Female
  • Health Surveys / methods
  • Humans
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / epidemiology
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / epidemiology
  • Male
  • Middle Aged
  • Mobile Applications
  • Multivariate Analysis
  • Patient Reported Outcome Measures*
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Severity of Illness Index
  • Symptom Assessment / methods
  • United States / epidemiology
  • Young Adult