American Journal of Obstetrics & Gynecology
Volume 202, Issue 5 , Pages 493.e1-493.e6, May 2010

Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization

Presented orally at the 30th Annual Scientific Meeting of the American Urogynecologic Society, Hollywood, FL, Sept. 24-26, 2009.

  • Gena C. Dunivan, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC
    • ,
  • Steve Heymen, PhD

      Affiliations

    • Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC
    • ,
  • Olafur S. Palsson, PsyD

      Affiliations

    • Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC
    • ,
  • Michael von Korff, ScD

      Affiliations

    • Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA
    • ,
  • Marsha J. Turner, MS

      Affiliations

    • Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC
    • ,
  • Jennifer L. Melville, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA
    • ,
  • William E. Whitehead, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC
    • Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, NC
    • Corresponding Author InformationReprints: William E. Whitehead, PhD, University of North Carolina at Chapel Hill, Campus Box 7080, Chapel Hill, NC 27599-7080

Received 24 July 2009; received in revised form 2 November 2009; accepted 12 January 2010. published online 11 March 2010.

Objective

We sought to estimate the frequency of self-reported fecal incontinence (FI), identify what proportion of these patients have a diagnosis of FI in their medical record, and compare health care costs and utilization in patients with different severities of FI to those without FI.

Study Design

Patients in a health maintenance organization were eligible and 1707 completed a survey. Patients with self-reported FI were assessed for a diagnosis of FI in their medical record for the last 5 years. Health care costs and utilization were obtained from claims data.

Results

FI was reported by 36.2% of primary care patients, but only 2.7% of patients with FI had a medical diagnosis. FI adversely affected quality of life and severe FI was associated with 55% higher health care costs (including 77% higher gastrointestinal-related health care costs) compared to continent patients.

Conclusion

Increased screening of FI is needed.

Key words: fecal incontinence, health care costs, health care utilization, screening

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 Cite this article as: Dunivan GC, Heymen S, Palsson OS, et al. Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. Am J Obstet Gynecol 2010;202:493.e1-6.

 Supported by R24 DK067674 from The National Institute of Diabetes, Digestive and Kidney Disorders and a grant from Novartis Pharmaceuticals.

PII: S0002-9378(10)00029-3

doi:10.1016/j.ajog.2010.01.018

American Journal of Obstetrics & Gynecology
Volume 202, Issue 5 , Pages 493.e1-493.e6, May 2010

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