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Erschienen in: International Urogynecology Journal 10/2013

01.10.2013 | Original Article

The effect of obesity on fecal incontinence symptom distress, quality of life, and diagnostic testing measures in women

verfasst von: David R. Ellington, Michael R. Polin, Jeff M. Szychowski, Luqin Deng, Holly E. Richter

Erschienen in: International Urogynecology Journal | Ausgabe 10/2013

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Abstract

Introduction and hypothesis

Weight-loss has been demonstrated to result in an improvement in fecal incontinence (FI) severity; however, there is a paucity of data addressing the differential impact of FI on the quality of life (QOL) and results of diagnostic testing across BMI categories. We wished to evaluate symptom distress, QOL, and diagnostic testing parameters among normal, overweight, and obese women with fecal incontinence.

Methods

Women undergoing evaluation for FI between 2003 and 2012 were identified. Participants completed validated, symptom-specific distress, impact, and general QOL measures including the Modified Manchester Questionnaire (MMHQ), which includes the Fecal Incontinence Severity Index (FISI), and the mental and physical component summary scores, MCS and PCS, respectively, of the Short Form-12. Anorectal manometry measures were also included. Multivariate regression analyses were performed.

Results

Participants included 407 women with a mean age ± SD of 56 ± 13. Multivariate analyses revealed no differences in symptom-specific distress and impact as measured by MMHQ, MCS, and PCS across BMI groups; however, obese women had increased resting and squeeze pressures compared with normal and overweight BMI women (p < 0.0001 and p < 0.0001; p = 0.007 and p = 0.004 respectively).

Conclusions

Obese women with FI did not have more general impact and symptom-specific distress and impact on quality of life compared with normal and overweight women. Obese women with FI had higher baseline anal resting and squeeze pressures suggesting a lower threshold to leakage with pressure increases.
Literatur
1.
Zurück zum Zitat Norton C, Whitehead W, Bliss DZ, Harari D, Lang J (2009) Conservative and pharmacological management of faecal incontinence in adults. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. Health Publication Ltd, Paris, p 1343 Norton C, Whitehead W, Bliss DZ, Harari D, Lang J (2009) Conservative and pharmacological management of faecal incontinence in adults. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. Health Publication Ltd, Paris, p 1343
2.
3.
Zurück zum Zitat Quander CR, Morris MC, Melson J et al (2005) Prevalence of and factors associated with fecal incontinence in a large community study of older individuals. Am J Gastroenterol 100:905–909PubMedCrossRef Quander CR, Morris MC, Melson J et al (2005) Prevalence of and factors associated with fecal incontinence in a large community study of older individuals. Am J Gastroenterol 100:905–909PubMedCrossRef
4.
Zurück zum Zitat Sailer M, Bussen D, Debus ES et al (1998) Quality of life in patients with benign anorectal disorders. Br J Surg 85:1716–1719PubMedCrossRef Sailer M, Bussen D, Debus ES et al (1998) Quality of life in patients with benign anorectal disorders. Br J Surg 85:1716–1719PubMedCrossRef
5.
Zurück zum Zitat Johansson JK, Lafferty J et al (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91:33–36 Johansson JK, Lafferty J et al (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91:33–36
6.
Zurück zum Zitat Szurszewski JH, Holt PR, Schuster MM et al (1989) Proceedings of a workshop entitled Neuromuscular function and dysfunction of the gastrointestinal tract. Dig Dis Sci 34:1135–1146PubMedCrossRef Szurszewski JH, Holt PR, Schuster MM et al (1989) Proceedings of a workshop entitled Neuromuscular function and dysfunction of the gastrointestinal tract. Dig Dis Sci 34:1135–1146PubMedCrossRef
8.
Zurück zum Zitat Sultan AH, Kamm MA, Hudson CN et al (1993) Anal sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911PubMedCrossRef Sultan AH, Kamm MA, Hudson CN et al (1993) Anal sphincter disruption during vaginal delivery. N Engl J Med 329:1905–1911PubMedCrossRef
9.
Zurück zum Zitat Snooks SJ, Henry MM, Swash M et al (1985) Faecal incontinence due to external sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature. Br J Obstet Gynaecol 92:824–828PubMedCrossRef Snooks SJ, Henry MM, Swash M et al (1985) Faecal incontinence due to external sphincter division in childbirth is associated with damage to the innervation of the pelvic floor musculature. Br J Obstet Gynaecol 92:824–828PubMedCrossRef
10.
Zurück zum Zitat Madoff RD, Parker SC, Varma MG et al (2004) Faecal incontinence in adults. Lancet 364:621–632PubMedCrossRef Madoff RD, Parker SC, Varma MG et al (2004) Faecal incontinence in adults. Lancet 364:621–632PubMedCrossRef
11.
Zurück zum Zitat Giordano P, Wexner SD et al (2001) The assessment of fecal incontinence in women. J Am Coll Surg 193(4):397–406PubMedCrossRef Giordano P, Wexner SD et al (2001) The assessment of fecal incontinence in women. J Am Coll Surg 193(4):397–406PubMedCrossRef
12.
Zurück zum Zitat Rao SC et al (2004) Diagnosis and management of fecal incontinence. American college of gastroenterology practice parameters committee. Am J Gastroenterol 99:1585–1604PubMedCrossRef Rao SC et al (2004) Diagnosis and management of fecal incontinence. American college of gastroenterology practice parameters committee. Am J Gastroenterol 99:1585–1604PubMedCrossRef
13.
Zurück zum Zitat Mokdad AH, Ford ES, Bowman BA et al (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 289:76–79PubMedCrossRef Mokdad AH, Ford ES, Bowman BA et al (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 289:76–79PubMedCrossRef
14.
Zurück zum Zitat Ogden CL, Carroll MD, Curtin LR et al (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295:1549–1555PubMedCrossRef Ogden CL, Carroll MD, Curtin LR et al (2006) Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295:1549–1555PubMedCrossRef
15.
Zurück zum Zitat Melville JL, Fan MY, Newton K et al (2005) Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol 193:2071–2076PubMedCrossRef Melville JL, Fan MY, Newton K et al (2005) Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol 193:2071–2076PubMedCrossRef
16.
Zurück zum Zitat Erekson EA, Sung VW, Myers DL et al (2008) Effect of body mass index on the risk of anal incontinence and defecatory dysfunction in women. Am J Obstet Gynecol 198:596e1–596e4CrossRef Erekson EA, Sung VW, Myers DL et al (2008) Effect of body mass index on the risk of anal incontinence and defecatory dysfunction in women. Am J Obstet Gynecol 198:596e1–596e4CrossRef
17.
Zurück zum Zitat Altman D, Falconer C, Rossner S et al (2007) The risk of anal incontinence in obese women. Int Urogynecol J Pelvic Floor Dysfunct 18:1283PubMedCrossRef Altman D, Falconer C, Rossner S et al (2007) The risk of anal incontinence in obese women. Int Urogynecol J Pelvic Floor Dysfunct 18:1283PubMedCrossRef
18.
Zurück zum Zitat Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B et al (2013) Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women. Surg Obes Relat Dis 9:69–76PubMedCrossRef Cuicchi D, Lombardi R, Cariani S, Leuratti L, Lecce F, Cola B et al (2013) Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women. Surg Obes Relat Dis 9:69–76PubMedCrossRef
19.
Zurück zum Zitat Burgio KL, Richter HE, Clements RH, Redden DT, Goode PS (2007) Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol 110:1034–1040PubMedCrossRef Burgio KL, Richter HE, Clements RH, Redden DT, Goode PS (2007) Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidly obese women. Obstet Gynecol 110:1034–1040PubMedCrossRef
20.
Zurück zum Zitat Sileri P, Franceshilli L, Cadeddu F, De Luca E, D’Ugo S, Tognoni V, Camperchiolo I, Benavoli D, Di Lorenzo N, Gaspari AL, Gentileschi P (2012) Prevalence of defaecatory disorders in morbidly obese patients before and after bariatric surgery. J Gastrointest Surg 16:62–66, discussion 66–67PubMedCrossRef Sileri P, Franceshilli L, Cadeddu F, De Luca E, D’Ugo S, Tognoni V, Camperchiolo I, Benavoli D, Di Lorenzo N, Gaspari AL, Gentileschi P (2012) Prevalence of defaecatory disorders in morbidly obese patients before and after bariatric surgery. J Gastrointest Surg 16:62–66, discussion 66–67PubMedCrossRef
21.
Zurück zum Zitat Kwon S, Visco AG, Fitzgerald MP, Ye W, Whitehead WE (2005) Pelvic Floor Disorders Network (PFDN) Validity and reliability of the modified Manchester health questionnaire in assessing patients with fecal incontinence. Dis Colon Rectum 48(323–31):331–334 Kwon S, Visco AG, Fitzgerald MP, Ye W, Whitehead WE (2005) Pelvic Floor Disorders Network (PFDN) Validity and reliability of the modified Manchester health questionnaire in assessing patients with fecal incontinence. Dis Colon Rectum 48(323–31):331–334
22.
Zurück zum Zitat Luo X, Lynn GM, Kakouras I, Edwards CL, Pietrobon R, Richardson W, Hey L (2003) Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine 28:1739–1745PubMed Luo X, Lynn GM, Kakouras I, Edwards CL, Pietrobon R, Richardson W, Hey L (2003) Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine 28:1739–1745PubMed
23.
Zurück zum Zitat WHO (2006) BMI classification. Global database on body mass index. WHO, Lyon. Accessed 18 October 2012 WHO (2006) BMI classification. Global database on body mass index. WHO, Lyon. Accessed 18 October 2012
24.
Zurück zum Zitat Markland AD, Richter HE, Burgio KL, Myers DL, Hernandez AL, Subak LL (2011) Weight loss improves fecal incontinence severity in overweight and obese women with urinary incontinence. Int Urogynecol J 22:1151–1157PubMedCrossRef Markland AD, Richter HE, Burgio KL, Myers DL, Hernandez AL, Subak LL (2011) Weight loss improves fecal incontinence severity in overweight and obese women with urinary incontinence. Int Urogynecol J 22:1151–1157PubMedCrossRef
25.
Zurück zum Zitat Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233PubMedCrossRef Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233PubMedCrossRef
26.
Zurück zum Zitat Tarlov AR, Ware JE, Greenfield S et al (1989) The medical outcomes study: an application of methods for monitoring the results of medical care. J Am Med Assoc 262:925CrossRef Tarlov AR, Ware JE, Greenfield S et al (1989) The medical outcomes study: an application of methods for monitoring the results of medical care. J Am Med Assoc 262:925CrossRef
27.
Zurück zum Zitat Hopman WM, Harrison MB, Coo H et al (2009) Associations between chronic disease, age, and physical and mental health status. Chronic Dis Can 29:108–116PubMed Hopman WM, Harrison MB, Coo H et al (2009) Associations between chronic disease, age, and physical and mental health status. Chronic Dis Can 29:108–116PubMed
28.
Zurück zum Zitat Wee CC, Davis RB, Hamel MB et al (2008) Comparing the SF-12 and SF-36 health status questionnaires in patients with and without obesity. Health Qual Life Outcome 6:11–18CrossRef Wee CC, Davis RB, Hamel MB et al (2008) Comparing the SF-12 and SF-36 health status questionnaires in patients with and without obesity. Health Qual Life Outcome 6:11–18CrossRef
29.
Zurück zum Zitat Richter HE, Kenton K, Huang L, Nygaard I, Kraus S, Whitcomb E, Chai TC, Lemack G, Sirls L, Dandreo KJ, Stoddard A (2010) The impact of obesity on urinary incontinence symptoms, severity, urodynamic characteristics and quality of life. J Urol 183:622–628PubMedCrossRef Richter HE, Kenton K, Huang L, Nygaard I, Kraus S, Whitcomb E, Chai TC, Lemack G, Sirls L, Dandreo KJ, Stoddard A (2010) The impact of obesity on urinary incontinence symptoms, severity, urodynamic characteristics and quality of life. J Urol 183:622–628PubMedCrossRef
30.
Zurück zum Zitat Henneman E, Somjen G, Carpenter DO (1965) Excitability and inhibitability of motoneurons of different sizes. J Neurophysiol 28:599–620PubMed Henneman E, Somjen G, Carpenter DO (1965) Excitability and inhibitability of motoneurons of different sizes. J Neurophysiol 28:599–620PubMed
Metadaten
Titel
The effect of obesity on fecal incontinence symptom distress, quality of life, and diagnostic testing measures in women
verfasst von
David R. Ellington
Michael R. Polin
Jeff M. Szychowski
Luqin Deng
Holly E. Richter
Publikationsdatum
01.10.2013
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 10/2013
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2103-1

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