Loose stools worsen life quality in women with faecal incontinence

In women with faecal incontinence (FI), faecal consistency of Bristol Stool Chart (BSC) ≥5 results in significantly worse clinical severity and quality of life (QoL), reports a study.

A total of 150 women (mean age 64.81 years) were included in this study. FI types varied, with the majority (64.38 percent) having urge FI, 15.06 percent having passive FI, and the rest (19.18 percent) having both.

Of these women, more than half (56.2 percent) had BSC ≥5, linked to bile acid malabsorption (20.5 percent), lactose malabsorption (17.9 percent), small intestinal bacterial overgrowth (14.3 percent), and fructose/sorbitol malabsorption (14.3 percent). There was a high prevalence of anorectal dysfunctions: 49.1 percent had external anal sphincter insufficiency, 9.8 percent internal, and 34.7 percent both.

Faecal consistency of BSC ≥5 significantly worsened clinical severity and QoL among women (St. Mark 17.3 vs 12.9). Those with BSC ≥5 also experienced issues in Fecal Incontinence Qualify of Life Scale dimension of lifestyle, coping, depression, and EuroQol 5-dimension of anxiety/depression, and pain/discomfort.

“Specific diagnostic and therapeutic approaches addressing loose stools are needed before any rehabilitation treatment,” the investigators said.

This cross-sectional observational study assessed anorectal physiology, neurophysiology, and faecal consistency with regard to clinical severity and QoL. Women with a BSC score of 5 or more underwent a breath test to detect bacterial overgrowth (small intestinal bacterial overgrowth), lactose or fructose/sorbitol malabsorption, and/or a cholestyramine test to detect bile acid malabsorption.

Finally, the investigators compared anorectal physiology, clinical severity, and QoL between participants with BSC ≥5 and BSC <5.