Fecal incontinence among patients with ulcerative colitis and relation with disease activity, and extent: A cross-sectional study.

BACKGROUND AND STUDY AIMS: Fecal incontinence reduces patients' quality of life. However, evidence regarding fecal incontinence in ulcerative colitis is limited.

PATIENTS AND

METHODS

To cross-sectionally examine disease activity, disease extent, the combination of disease activity and disease extent, along with fecal incontinence in ulcerative colitis. Fecal incontinence and severe fecal incontinence were defined on the basis of the frequency of incontinence obtained using a self-administered questionnaire. Complete mucosal healing and mucosal healing were defined as Mayo endoscopic subscores of 0 and 1, respectively. Information on clinical remission and disease extent was collected from the medical records.

RESULTS

This study included 290 ulcerative colitis patients (mean age: 50.3 ± 16.0 years). Disease extents were 119, 80, 84, and 7 cases of total colitis, left-sided colitis, proctitis, and others, respectively. The rates of male sex, complete mucosal healing (CMH), mucosal healing (MH), clinical remission (CR), fecal incontinence, and severe fecal incontinence were 57.6%, 25.2%, 61.0%, 59.3%, 13.8%, and 5.9%, respectively. CMH, MH, and CR were independently inversely associated with fecal incontinence and severe fecal incontinence, respectively. During the active stage of total colitis in ulcerative colitis there was an independent and positive association with fecal incontinence and severe fecal incontinence (adjusted OR 2.51 [95% CI 1.22-5.18], and adjusted OR 3.95 [95% CI 1.38-11.85]). Other disease extents were not associated with fecal incontinence or severe fecal incontinence, regardless of active stage.

CONCLUSIONS

In ulcerative colitis, disease activity was independently inversely associated with fecal incontinence. The total colitis with active stage was significantly positively associated with fecal incontinence.