Dig Liver Dis. 2022 Sep;54(9):1195-1201. doi: 10.1016/j.dld.2022.01.125. Epub 2022 Feb 3.

Simon Kurt ¹, Bénédicte Caron ², Celia Gouynou ¹, Patrick Netter ³, Carolynne J Vaizey ⁴, Steven D Wexner ⁵, Silvio Danese ⁶, Cédric Baumann ⁷, Laurent Peyrin-Biroulet ⁸

Author information

¹Nancy University Hospital, Department of Gastroenterology, F-54000 Nancy, France.

²Nancy University Hospital, Department of Gastroenterology, F-54000 Nancy, France; Nancy University Hospital, DRCI, F-54000 Nancy, France.

³Ingénierie Moléculaire et Ingénierie Articulaire (IMoPA), UMR-7365 CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.

⁴Ingénierie Moléculaire et Ingénierie Articulaire (IMoPA), UMR-7365 CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France; Department of Surgery, St Mark's Hospital and Academic Institute, London, United Kingdom; Department of Surgery and Cancer, Imperial College, London, United Kingdom.

⁵Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, United States.

⁶Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, United States; Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele Milano Italy.

⁷Unit of methodology, data management and statistic, Nancy University Hospital, Vandoeuvre-lès-Nancy, France.

⁸Nancy University Hospital, Department of Gastroenterology, F-54000 Nancy, France; University of Lorraine, Inserm, NGERE, F-54000 Nancy, France. Electronic address: peyrinbiroulet@gmail.com.

Abstract

Background: Faecal incontinence (FI) is a disabling condition in patients with inflammatory bowel disease (IBD). The diagnosis of FI is not easy as patients are reluctant to report this embarrassing symptom. The objectives of this study were to characterize the prevalence of FI in IBD patients using available scoring systems, and to identify associated risk factors.

Methods: A FI clinic was implemented in routine practice between January 2020 and April 2021. FI was defined as a Wexner score ≥5. Factors associated with FI were analyzed.

Results: A total of 319 consecutive patients with IBD were included. The prevalence of FI was 16.4% (53/319). Age >45 years at inclusion (Odd ratio (OR)=3.33, Confidence interval (CI) 95% 1.40-7.94), diarrhea (three stools at least per day) (OR=2.94, CI 95% 1.16-7.45), stool consistency according to the Bristol stool chart (OR=2.23, CI 95% 1.00-4.99), and abdominal pain (OR=2.24, CI 95% 1.10-4.53) were independently associated with FI in a multivariate model analysis.

Conclusions: Approximately one fifth of IBD patients reported FI in this real-world cohort, using an available scoring system. Increased age, diarrhea, stool consistency according to the Bristol stool chart, and abdominal pain were associated with FI. A systematic screening of FI would allow a better management of this disabling condition.