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Shared Risk Factors for Constipation, Fecal Incontinence, and Combined Symptoms in Older U.S. Adults
Author(s) -
Andy Uduak U.,
Vaughan Camille P.,
Burgio Kathryn L.,
Alli Foluke M.,
Goode Patricia S.,
Markland Alayne D.
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14521
Subject(s) - medicine , constipation , odds ratio , depression (economics) , fecal incontinence , confidence interval , population , national health and nutrition examination survey , physical therapy , gastroenterology , environmental health , economics , macroeconomics
Objectives To estimate the prevalence of constipation, fecal incontinence ( FI ), and combined symptoms and to identify shared factors associated with bowel symptoms in older U.S. men and women Design Population‐based cross‐sectional study. Setting National Health and Nutrition Examination Survey (2005–2010). Participants Women and men aged 50 and older. Measurements Constipation was defined as hard stool consistency on the validated Bristol Stool Form Scale or stool frequency of fewer than three bowel movements per week. FI was defined as at least monthly loss of solid, liquid, or mucus stool. Combined symptoms was defined as constipation and FI . Multinomial multivarible models adjusted for age, race, socioeconomic status, education, self‐rated health, depression, impairments in activities of daily living, and number of comorbidities. Results Women (n = 3,078) reported higher prevalence of bowel symptoms than men (constipation 11.8% vs 4.7%%, FI 11.2% vs 8.6%, combined symptoms 1.4% vs 0.4%). In adjusted models, women had greater odds of having constipation (odds ratio ( OR ) = 3.0, 95% confidence interval ( CI ) = 2.3–3.8), FI ( OR = 1.4, 95% CI = 1.1–1.8), and combined symptoms ( OR = 4.6, 95% CI = 2.0–10.2) than men. Shared risk factors included poor self‐rated health and depression symptoms (constipation: OR = 1.8, 95% CI = 1.4–2.4 and OR = 1.8, 95% CI = 1.0–3.2; FI : OR = 1.6, 95% CI = 1.2–2.2 and OR = 2.3 95% CI = 1.4–3.6; combined symptoms: OR = 2.6 95% CI = 1.5–4.8 and OR = 4.6, 95% CI = 1.3–16.4). Conclusion When defining constipation and FI using validated instruments, women had a much higher prevalence of constipation than men, whereas men had a higher prevalence of FI than constipation. Shared risk factors reflect the negative effect that bowel symptoms have on quality of life.