P133 Frequency of fecal incontinence and factors associated with its development in patients with Inflammatory Bowel Disease
F. Gonzalez-Ortiz*, N. Bueno-Hernandez, J. Yamamoto-Furosho
IBD Clinic, Instituto Nacional de Ciencias Medicas y Nutricion, Gastroenterology, Mexico, Mexico
There is little information about the prevalence of fecal incontinence (FI) in patients with inflammatory bowel disease (IBD). Risk factors that have been associated with FI is the presence of perianal fistula and ileo-anal pouch surgery. However, there is no enough evidence if during relapse symptoms such as urgency, frequent watery or loose stools could increase the risk for FI and if pelvic floor disorders by obstetric complications, vaginal delivery and anal sphincter surgery have been associated with FI in patients with IBD.The aim of this study is to determine the frequency of FI and the factors associated with their development in IBD patients.
A cross-sectional study was conducted in patients with a confirmed diagnosis of IBD. We analyzed 96 patients [78 patients with Ulcerative Colitis (UC) and 18 with Crohn´s disease (CD)]. Demographic and clinical data were collected for the analysis. Current disease activity was reported using the Harvey Bradshaw Index for CD and Mayo score for UC. Risk factors for incontinence ( > 3 vaginal deliveries, obstetric complications of pelvic floor, anal sphincter surgery and the presence of perianal fistula) were investigated and Wexner scale to assess the presence of incontinence was applied. Descriptive statistics were used and odds ratios (OR) to determine the strength of association. Data were analyzed using SPSS, a P value <0.05 was considered as significant.
In patients with UC, the mean age was 43 years, 54% female and 46% male. In 56% of the patients the extent of disease was pancolitis and 82% had intermittent clinical course (less than 2 relapses per year), 45% of patients had extraintestinal manifestations and only the 5% had ileo-anal pouch surgery. Thirty-one percent of patients with UC had FI; the factor associated with the presence of FI was the clinical activity of the disease (P= 0.002, OR = 7.5; 95% CI = 2.0 - 28). In patients with CD the mean age was 55 years, 67 % female and 33% male. In 67% the localization was ileocolonic, and the behavior in 50% was non-structuring, non-penetrating and 39% had extraintestinal manifestations. Fourty-four percent of patients with CD had FI; the factor associated with the presence of FI was the inflammatory behaviour of the disease (P= 0.04, OR=1.8; IC95% 1.1 - 2.2).
The frequency of FI in UC was 31% and 44% in CD. The only factor associated in patients with UC was the disease activity and the inflammatory behavior in CD patients.