Int Urogynecol J. 2024 Apr 24. doi: 10.1007/s00192-024-05776-6. Online ahead of print.

Uduak U Andy ¹, Jeniffer Iriondo-Perez ², Benjamin Carper ², Holly E Richter ³, Keisha Y Dyer ⁴, Maria Florian-Rodriguez ⁵, G Sarah Napoe ⁶, Deborah Myers ⁷, Michele O'Shea ⁸, Donna Mazloomdoost ⁹, Marie G Gantz ²; Pelvic Floor Disorders Network

Author information

¹Department of Obstetrics and Gynecology, University of Pennsylvania, 3737 Market Street, 12Th Floor, Philadelphia, PA, 19104, USA. Uduakumoh.andy@pennmedicine.upenn.edu.

²Social, Statistical & Environmental Sciences, RTI International, Research Triangle Park, Durham, NC, USA.

³Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.

⁴Department of Obstetrics and Gynecology Kaiser Permanente, San Diego, CA, USA.

⁵Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

⁶Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

⁷Department of Obstetrics and Gynecology, Brown University, Providence, RI, USA.

⁸Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.

⁹The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.

Abstract

Introduction and hypothesis: The goal of this study was to determine whether dietary fat/fiber intake was associated with fecal incontinence (FI) severity.

Methods: Planned supplemental analysis of a randomized clinical trial evaluating the impact of 12-week treatment with percutaneous tibial nerve stimulation versus sham in reducing FI severity in women. All subjects completed a food screener questionnaire at baseline. FI severity was measured using the seven-item validated St. Mark's (Vaizey) FI severity scale. Participants also completed a 7-day bowel diary capturing the number of FI-free days, FI events, and bowel movements per week. Spearman's correlations were calculated between dietary, St. Mark's score, and bowel diary measures.

Results: One hundred and eighty-six women were included in this analysis. Mean calories from fats were 32% (interquartile range [IQR] 30-35%). Mean dietary fiber intake was 13.9 ± 4.3 g. The percentage of calories from fats was at the higher end of recommended values, whereas fiber intake was lower than recommended for adult women (recommended values: calories from fat 20-35% and 22-28 g of fiber/day). There was no correlation between St. Mark's score and fat intake (r = 0.11, p = 0.14) or dietary fiber intake (r = -0.01, p = 0.90). There was a weak negative correlation between the number of FI-free days and total fat intake (r = -0.20, p = 0.008). Other correlations between dietary fat/fiber intake and bowel diary measures were negligible or nonsignificant.

Conclusion: Overall, in women with moderate to severe FI, there was no association between FI severity and dietary fat/fiber intake. Weak associations between FI frequency and fat intake may suggest a role for dietary assessment in the evaluation of women with FI.