Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Aug 6, 2016; 7(3): 447-452
Published online Aug 6, 2016. doi: 10.4292/wjgpt.v7.i3.447
Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia
Duminda Subasinghe, Navarathna Mudiyanselage Meththananda Navarathna, Dharmabandhu Nandadeva Samarasekera
Duminda Subasinghe, Navarathna Mudiyanselage Meththananda Navarathna, Dharmabandhu Nandadeva Samarasekera, Department of Surgery, Faculty of Medicine, University Surgical Unit, the National Hospital of Sri Lanka, Colombo 08, Sri Lanka
Author contributions: Subasinghe D, Navarathna NMM and Samarasekera DN were involved in study planning, data collection and analysis, and writing of the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the ethics review committee of the National Hospital of Sri Lanka.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of Interest to disclose.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dharmabandhu Nandadeva Samarasekera, MBBS (Colombo), MS, MD (East Anglia), FRCS (Eng), FRCS (Edin), PG Cert MedEd (Dundee), Professor of Surgery and Head, Department of Surgery, Faculty of Medicine, University Surgical Unit, the National Hospital of Sri Lanka, Kynsey Road, Colombo 08, Sri Lanka. samarasekera58@yahoo.co.uk
Telephone: +94-77-5761000 Fax: +94-11-2691581
Received: December 9, 2015
Peer-review started: December 11, 2015
First decision: January 4, 2016
Revised: March 9, 2016
Accepted: April 14, 2016
Article in press: April 18, 2016
Published online: August 6, 2016
Abstract

AIM: To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients.

METHODS: All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis (UC) or Crohn’s disease (CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI (Vaizey score), and quality of life (IBD-Q) were collected. Data were analyzed using SPSS version 21.

RESULTS: There were 184 patients (women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC (male/female ratio = 1:1.5) and a male preponderance for CD (male/female = 2:1). Forty-eight (26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women (n = 34) and 29.2% were men (n = 14) with an average age of 52.7 years (range, 20-78 years). Average age of onset of FI was 48.6 (range, 22-74) years. Ten percent (n = 5) reported regular FI. Incontinence to flatus was seen in 33.3% (n = 16), to liquid faeces in 56.2% (n = 27), to solid faeces in 6.2% (n = 3) and to all three in 4.1% (n = 2). Twenty-one percent (n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age (P = 0.005) and gender (P < 0.001). QOL in our cohort of patients was significantly affected by FI.

CONCLUSION: In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients.

Keywords: Inflammatory bowel disease, Quality of life, Faecal incontinence, Crohn’s disease

Core tip: This was a prospective study involving 184 patients with inflammatory bowel disease (IBD). It was designed to analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in IBD patients in a tertiary care center. In our study, nearly 25% of patients reported the symptoms of FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition.