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Factors Associated With Care Seeking Among Women With Accidental Bowel Leakage

Brown, Heidi W. MD*; Wexner, Steven D. MD; Lukacz, Emily S. MD*

Female Pelvic Medicine & Reconstructive Surgery: March/April 2013 - Volume 19 - Issue 2 - p 66–71
doi: 10.1097/SPV.0b013e31828016d3
AUGS Conference Presentation

Objective The aim of this study was to characterize factors associated with care seeking among women with accidental bowel leakage (ABL).

Methods A secondary analysis of 938 women with ABL identified in a community-based Internet survey of 5817 US women 45 years or older was performed. Demographics, medical history, incontinence severity, quality of life, coping, and care seeking were assessed using questions derived from validated questionnaires. Accidental bowel leakage was defined as at least 1 episode of stool leakage in the past year in the absence of acute diarrheal illness. Women with ABL were asked, “Have you ever talked to a physician about accidental leakage of stool and/or gas?” and were designated “care seekers” if they responded affirmatively. Factors associated with care seeking on univariate analysis with P < 0.1 were included in a multivariate model.

Results The response rate overall was 85% (5817/6873) with 1096 women (19%) reporting ABL. Care-seeking data were available for 938 (86%). Of these, 85% were white, 6% were black/African American, 5% were of Hispanic/Latina/Spanish origin, and 4% other; median age was 55 to 59 years (range, 45 to 49, >75 years), and 87% were insured. Only 29% (268/938) of those with ABL sought care. Multivariate analysis demonstrated that care seekers were more likely to have a primary care physician (PCP), to have heard of ABL, and to have suffered longer with more severe leakage.

Conclusions More than two thirds of women with ABL do not seek care. Because those with a PCP and those who have heard of the condition are more likely to seek care, educating the public about ABL and encouraging establishment of care and communication with a PCP may decrease silent suffering.

Educating patients about accidental bowel leakage and encouraging establishment of care with a primary care physician may decrease silent suffering and increase care seeking.

From the *Department of Reproductive Medicine, UC San Diego Health System, La Jolla, CA; and †Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL.

Reprints: Heidi W. Brown, MD, Department of Reproductive Medicine, UC San Diego Health System, 9350 Campus Point Dr, no. 0974, La Jolla, CA 92037. E-mail:

Conflicts of interest and source of funding: Heidi Brown has nothing to disclose. Steven Wexner is a paid consultant in the field of fecal incontinence for Salix, Ventrus, Renew Medical, Inc, Mediri Therapeutics, and Medtronic. Emily Lukacz is a paid consultant for Pfizer, consultant and recipient of grant funding from Johnson and Johnson and research and educational grant funding from the National Institutes of Health and Renew Medical, Inc. Renew Medical, Inc. markets devices for the treatment of fecal incontinence.

Presented as oral podium presentation at the 2012 AUGS Annual Scientific Meeting, Thursday, October 4, 2012.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins