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Fecal incontinence among morbid obese women seeking for weight loss surgery: an underappreciated association with adverse impact on quality of life

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Morbid obesity is associated with urinary incontinence (UI). The study purpose was to determine the prevalence of fecal incontinence (FI), its associated risk factors, and its impact on quality of life (QOL) in morbidly obese women.

Materials and methods

A questionnaire-based study on morbidly obese women [body mass index (BMI) ≥ 35 m/kg2], attending a bariatric surgery seminar, was conducted. Data included demographics, past medical, surgical and obstetric history, and obesity-related co-morbidities. Patients who reported of FI, completed the Cleveland Clinic Foundation Fecal Incontinence scale (CCF-FI) and the Fecal Incontinence Quality of Life scale (FIQL).

Results

Participants included 256 women [median age 45 years (19–70)] and mean BMI of 49.3 ± 9.4 m/kg2. FI was reported in 63%. History of obstetric injury (OR: 2.4, 95% CI: 1.33–4.3; p < 0.001) and UI (OR: 1.2, 95% CI: 1.1–1.4; p < 0.001) were significantly associated with FI. There was no association with age, BMI, parity, and presence of diabetes or hypertension. Median CCF-FI score was 7 (1–20); 34.5% scored ≥10. Incontinence for gas was the most frequent type (87%) of FI, followed by incontinence for liquids (80%), which also had the highest impact on QOL (p < 0.01). Mean FIQL scores were >3 for all four domains studied. CCF-FI scores were significantly correlated with FIQL scores in all domains (p = 0.02).

Comment

The prevalence of FI among morbidly obese women may be much higher than the rates reported in the general population. FI has adverse effects on QOL. Its correlation with UI suggests that morbid obesity may pose a risk of global pelvic floor dysfunction.

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Authors and Affiliations

  1. Division of Colorectal and Pelvic Floor Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA

    Nir Wasserberg, Mark Haney, Patrizio Petrone, Peter Crookes, Jason Rosca, Manfred Ritter & Howard S. Kaufman

  2. Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, 49100, Israel

    Nir Wasserberg

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  1. Nir Wasserberg
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  2. Mark Haney
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  3. Patrizio Petrone
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  4. Peter Crookes
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  5. Jason Rosca
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  6. Manfred Ritter
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  7. Howard S. Kaufman
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Correspondence to Nir Wasserberg.

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Wasserberg, N., Haney, M., Petrone, P. et al. Fecal incontinence among morbid obese women seeking for weight loss surgery: an underappreciated association with adverse impact on quality of life. Int J Colorectal Dis 23, 493–497 (2008). https://doi.org/10.1007/s00384-007-0432-6

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  • DOI: https://doi.org/10.1007/s00384-007-0432-6

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