Fecal incontinence as a hidden disorder among adults aged over 50 years

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INTRODUCTION: FI adversely affects nearly every aspect of daily life. Patients often avoid telling symptoms, and physicians may neglect to inquire about FI symptoms. This study aims to audit the point prevalence of FI, and risk factors among participants older than 50 years old. MATERIALS AND METHODS: Participants older than 50 years whose complaints other than FI were included into the study. They were strictly questioned about FI symptoms according to Rome 4 criteria. Demographics, comorbidities, history of anal surgery, and obstetric history were recorded. An anorectal examination was performed for all participants. Anal resting and squeezing pressures were also measured by conventional anal manometry. RESULTS: Of 476 patients invited, 202 participants were enrolled. Forty-eight participants (23.8%) were diagnosed with FI, with nearly half of cases disclosed by patients only after targeted clinical evaluation and discussion following physical examination and anal manometry. Anal resting (median 30 vs. 50 mmHg, p < 0.001) and squeezing (median 65 vs. 100 mmHg, p < 0.001) pressures were significantly low in participants with FI. Female sex (OR 2.50, p = 0.028), age over 70 years (OR 2.66, p = 0.039), comorbidity burden (one comorbidity: OR 3.54, p = 0.018 two or more: OR 3.25, p = 0.025), and history of anal surgery (OR 2.50, p = 0.028) were identified as independent risk factors for FI. CONCLUSION: The rate of FI was found to be high among participants aged over 50 years. Physicians should carefully inquire about FI symptoms, as the condition often remains underreported. Physician awareness and targeted clinical evaluation are important for the recognition of possible FI and for encouraging patient disclosure.

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