How Prevalent Is Fecal Incontinence in Patients With Inflammatory Bowel Disease?

Man holding toilet tissue roll in bathroom looking at loo
Using scoring systems, researchers investigated the prevalence and risk factors for fecal incontinence in patients with IBD.

A total of 16.4% of patients with inflammatory bowel disease (IBD) experience fecal incontinence, according to a study published in Digestive and Liver Disease.

For the analysis, researchers enrolled 319 patients with IBD from Nancy University Hospital in France. Study participants were screened for fecal incontinence using a nonvalidated questionnaire, which included the Wexner score and Vaizey score for measuring severity of fecal incontinence and its effect on QOL. Fecal incontinence was defined as having a Wexner score of 5 or greater. The Bristol stool chart was used to determine stool consistency. Researchers collected additional patient and disease characteristics, such as sociodemographic data, the presence of intestinal pain, and history of intestinal resection to assess for trends with the presence of fecal incontinence.

Study participants had a median age of 41 (IQR, 31-53) years, 52% were women, and 19.7% actively smoked tobacco.

The nonvalidated questionnaire indicated that 15.4% of patients experienced fecal incontinence. By definition of the Wexner score, 16.4% of patients had fecal incontinence. Risk factors for fecal incontinence included being aged over 45 years (odds ratio [OR], 3.73; CI 95%, 1.66-8.40), having stool consistency meeting the Bristol stool chart (OR, 4.19; CI 95%, 2.22-7.90), diarrhea (OR, 4.16; CI 95%, 2.01-8.62), transit disorders (OR, 2.86; CI 95%, 1.57-5.22), and abdominal pain (OR, 2.32; CI 95%, 1.27-4.22).

Study limitations include selection bias, as the patients enrolled in the study came from a referral center where individuals had severe symptoms.

“Increased recognition, regular discussions between patient and physician, and the use of available scoring systems could improve the diagnosis of [fecal incontinence] in [Crohn disease] and [ulcerative colitis] patients,” the study authors wrote. “Because FI can reduce quality of life, an objective FI assessment must be considered when [evaluating] IBD patients.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Kurt S, Caron B, Gouynou C, et al. Faecal incontinence in inflammatory bowel disease: The Nancy experience. Dig Liver Dis. Published online February 3, 2022. doi:10.1016/j.dld.2022.01.125