Top

International Urogynecology Journal

Published in:

01-08-2010 | Original Article

Prevalence of bowel symptoms in women with pelvic floor disorders

Authors: Fareesa Raza-Khan, Jacqueline Cunkelman, Lior Lowenstein, Susan Shott, Kimberly Kenton

Published in: International Urogynecology Journal | Issue 8/2010

Abstract

Introduction and hypothesis

To determine the prevalence of a variety of bowel symptoms in women with pelvic floor disorders

Methods

We reviewed charts of consecutive new patients presenting to our urogynecologic clinic between July 2006 and April 2008. Women completed two bowel symptom questionnaires: (1) a nonvalidated questionnaire inquiring about symptoms of fecal/flatal incontinence, painful bowel movements, difficulties in bowel movement, and the need for splinting and (2) the validated, Colorectal–Anal Distress Inventory (CRADI) subscale of the short form of the Pelvic Floor Distress Inventory. Demographic and clinical information were extracted from patients’ charts.

Results

Four hundred sixty-three women were included. Only 3% of the women presented with defecatory dysfunction or fecal incontinence as their chief complaint. However, 83% answered affirmatively to the presence of at least one CRADI bowel symptom. The most common bowel symptom was incomplete emptying at the end of a bowel movement (56%), followed by straining to have a bowel movement (55%), and flatal incontinence (54%).

Conclusions

Women rarely seek urogynecologic care primarily for bowel symptoms, although they have a high prevalence of bowel symptoms.

Fialkow MF, Melville JL, Lentz GM, Miller EA, Miller J, Fenner DE (2003) The functional and psychosocial impact of fecal incontinence on women with urinary incontinence. Am J Obstet Gynecol 189:127–129CrossRefPubMed

Perry S, Shaw C, McGrother C, Matthews RJ, Assassa RP, Dallosso H et al (2002) Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut 50:480–484CrossRefPubMed

Abramov Y, Sand PK, Botros SM, Gandhi S, Miller J-JR, Nickolov A et al (2005) Risk factors for female anal incontinence: new insight through the Evanston-Northwestern twin sisters study. Obstet Gynecol 106:726–732PubMed

Bharucha AE, Zinsmeister AR, Locke GR, Seide BM, McKeon K, Schleck CD et al (2005) Prevalence and burden of fecal incontinence: a population-based study in women. Gastroenterology 129:42–49CrossRefPubMed

Nelson R, Furner S, Jesudason V (1998) Fecal incontinence in Wisconsin nursing homes: prevalence and associations. Dis Colon Rectum 41:1226–1229CrossRefPubMed

Nelson R, Norton N, Cautley E, Furner S (1995) Community-based prevalence of anal incontinence. JAMA 274:559–561CrossRefPubMed

Johanson JF, Lafferty J (1996) Epidemiology of fecal incontinence: the silent affliction. Am J Gastroenterol 91:33–36PubMed

Melville JL, Fan M-Y, Newton K, Fenner D (2005) Fecal incontinence in US women: a population-based study. Am J Obstet Gynecol 193:2071–2076CrossRefPubMed

Pollack J, Nordenstam J, Brismar S, Lopez A, Altman D, Zetterstrom J (2004) Anal incontinence after vaginal delivery: a five-year prospective cohort study. Obstet Gynecol 104:1397–1402PubMed

10.

Gordon D, Groutz A, Goldman G, Avni A, Wolf Y, Lessing JB et al (1999) Anal incontinence: prevalence among female patients attending a urogynecologic clinic. Neurourol Urodyn 18:199–204CrossRefPubMed

11.

Jackson SL, Weber AM, Hull TL, Mitchinson AR, Walters MD (1997) Fecal incontinence in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 89:423–427CrossRefPubMed

12.

Meschia M, Buonaguidi A, Pifarotti P, Somigliana E, Spennacchio M, Amicarelli F (2002) Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse. Obstet Gynecol 100:719–723CrossRefPubMed

13.

Nichols CM, Gill EJ, Nguyen T, Barber MD, Hurt WG (2004) Anal sphincter injury in women with pelvic floor disorders. Obstet Gynecol 104:690–696PubMed

14.

Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113CrossRefPubMed

15.

Snooks SJ, Barnes PR, Swash M, Henry MM (1985) Damage to the innervation of the pelvic floor musculature in chronic constipation. Gastroenterology 89:977–981PubMed

16.

Gustilo-Ashby AM, Paraiso MFR, Jelovsek JE, Walters MD, Barber MD (2007) Bowel symptoms 1 year after surgery for prolapse: further analysis of a randomized trial of rectocele repair. Am J Obstet Gynecol 197(76):e71–e75

17.

Kenton K, Shott S, Brubaker L (1999) Outcome after rectovaginal fascia reattachment for rectocele repair. Am J Obstet Gynecol 181:1360–1363, discussion 1363–1364CrossRefPubMed

18.

Lewicky-Gaupp C, Morgan DM, Chey WD, Muellerleile P, Fenner DE (2008) Successful physical therapy for constipation related to puborectalis dyssynergia improves symptom severity and quality of life. Dis Colon Rectum 51:1686–1691CrossRefPubMed

19.

Snooks SJ, Setchell M, Swash M, Henry MM (1984) Injury to innervation of pelvic floor sphincter musculature in childbirth. Lancet 2:546–550CrossRefPubMed

20.

Snooks SJ, Swash M, Henry MM, Setchell M (1985) Risk factors in childbirth causing damage to the pelvic floor innervation. Br J Surg 72(Suppl):S15–17CrossRefPubMed

21.

Sorensen M, Tetzschner T, Rasmussen OO, Bjarnesen J, Christiansen J (1993) Sphincter rupture in childbirth. Br J Surg 80:392–394CrossRefPubMed

22.

Casey BM, Schaffer JI, Bloom SL, Heartwell SF, McIntire DD, Leveno KJ (2005) Obstetric antecedents for postpartum pelvic floor dysfunction. Am J Obstet Gynecol 192:1655–1662CrossRefPubMed

23.

Guise J-M, Morris C, Osterweil P, Li H, Rosenberg D, Greenlick M (2007) Incidence of fecal incontinence after childbirth. Obstet Gynecol 109:281–288PubMed

24.

Nichols CM, Nam M, Ramakrishnan V, Lamb EH, Currie N (2006) Anal sphincter defects and bowel symptoms in women with and without recognized anal sphincter trauma. Am J Obstet Gynecol 194:1450–1454CrossRefPubMed

25.

Erekson EA, Sung VW, Myers DL, Erekson EA, Sung VW, Myers DL (2008) Effect of body mass index on the risk of anal incontinence and defecatory dysfunction in women. Am J Obstet Gynecol 198(596):e591–e594

26.

Hunskaar S (2008) A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women. Neurourol Urodyn 27:749–757CrossRefPubMed

27.

Kudish BI, Iglesia CB, Sokol RJ, Cochrane B, Richter HE, Larson J et al (2009) Effect of weight change on natural history of pelvic organ prolapse. Obstet Gynecol 113:81–88PubMed

28.

Wasserberg N, Haney M, Petrone P, Crookes P, Rosca J, Ritter M et al (2008) Fecal incontinence among morbid obese women seeking for weight loss surgery: an underappreciated association with adverse impact on quality of life. Int J Colorectal Dis 23:493–497CrossRefPubMed

29.

Wasserberg N, Haney M, Petrone P, Ritter M, Emami C, Rosca J et al (2007) Morbid obesity adversely impacts pelvic floor function in females seeking attention for weight loss surgery. Dis Colon Rectum 50:2096–2103CrossRefPubMed

30.

Elkadry E, Kenton K, White P, Creech S, Brubaker L (2003) Do mothers remember key events during labor? Am J Obstet Gynecol 189:195–200CrossRefPubMed

Title: Prevalence of bowel symptoms in women with pelvic floor disorders
Authors: Fareesa Raza-Khan
Jacqueline Cunkelman
Lior Lowenstein
Susan Shott
Kimberly Kenton
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 8/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-010-1143-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence of bowel symptoms in women with pelvic floor disorders

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2010

Erratum to: Analysis of early outcome: Burch procedure versus pubovaginal sling

Vaginal delivery and pelvic floor dysfunction: current evidence and implications for future research

Test–retest reliability of the cotton swab (Q-tip®) test in the evaluation of the incontinent female

Validation of the Prolapse Quality of Life (P-QOL) questionnaire in Thai version

Systematic review of the accuracy of ultrasound as the method of measuring bladder wall thickness in the diagnosis of detrusor overactivity

Symptomatic urinary tract infections after surgery for prolapse and/or incontinence