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Racial Differences in Fecal Incontinence in Community-Dwelling Women From the EPI Study

Berger, Mitchell B. MD, PhD; DeLancey, John O. MD; Fenner, Dee E. MD

Female Pelvic Medicine & Reconstructive Surgery: May/June 2013 - Volume 19 - Issue 3 - p 169–174
doi: 10.1097/SPV.0b013e3182874709
Original Articles

Objectives Despite its prevalence and associated distress, fecal incontinence (FI) is not well understood. There are limited data regarding associations between FI and race. The goal of this study was to estimate the prevalence of FI, and to secondarily identify demographic, lifestyle, and medical factors associated with FI, especially with regard to race.

Methods This was a planned secondary analysis of a population-based cross-sectional telephone interview survey of 2812 black and white community-dwelling women living in southeastern Michigan. The primary outcome measured was the prevalence of self-reported FI, defined as any loss of stool during the previous 12 months. Logistic regression modeling was used to identify characteristics independently associated with FI.

Results Of the subjects, 16.7% reported FI in the previous year. Fecal incontinence was approximately twice as common in white women (20%) as black women (11%). Factors associated with FI differed between the 2 races, although its prevalence in both racial groups increases with higher numbers of medical comorbidities, increased frequency of bowel movements per week, and depression.

Conclusions One in 6 women report FI, although it occurs one-half as often in black as in white women. Although there are common characteristics shared by women with FI in both racial groups, white women experience FI in complex with other pelvic floor disorders. For black women, FI is an isolated pelvic floor disorder associated with mobility impairment.

Of community-dwelling women, 16.7% self-report fecal incontinence, with differences in risk factors noted between black and white women.

From the Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.

Reprints: Mitchell B. Berger, MD, PhD, Department of Obstetrics and Gynecology, University of Michigan, L4100 Women’s Hospital, 1500 E Medical Center Dr, SPC 5276, Ann Arbor, MI 48109-5276. E-mail:

Supported by National Institutes of Health Grant R01HD/AG41123 with additional investigator support from the Office for Research on Women’s Health and the National Institute of Child Health and Human Development SCOR 1 P50 HD044406 and by grants paid to the University of Michigan to support research by the Pelvic Floor Research Group led by John O. DeLancey.

Presented at the 33rd Annual Scientific Meeting of the American Urogynecologic Society, October 3–6, 2012, Chicago, IL.

The authors have declared they have no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins