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Diet Modifications in Older Women With Fecal Incontinence

A Qualitative Study

Andy, Uduak U., MD*; Ejike, Nancy, BS, MPH*†; Khanijow, Kavita D., MD*; Flick, Lorraine C., MS*; Markland, Alayne D., DO‡§; Arya, Lily A., MD, MS*; Frasso, Rosemary, PhD, MSc, CPH†∥

Female Pelvic Medicine & Reconstructive Surgery: February 8, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000702
Original Article: PDF Only

Objective The aim of the study was to investigate dietary modification strategies used by community-dwelling older women to manage their fecal incontinence (FI).

Methods We conducted a qualitative study with focus groups wherein women 65 years and older with FI shared their experiences managing the condition. We explored the following: (1) association between diet and FI symptoms, (2) dietary strategies and modifications used by older women to manage FI, and (3) patient input about disseminating diet modification information and strategies. All focus groups were audio recorded, transcribed, coded, and qualitatively analyzed to identify relevant themes.

Results Twenty-one women participated in 3 focus groups. All participants were aware that diet plays a key role in their experience of FI and women described a method of “trial and error” in identifying specific aspects of their diet that contributed to their FI symptoms. Women reported modifications including avoiding or limiting several foods and food categories, changing certain methods of food preparation, as well as varying the amounts and frequency of meals to manage their FI. Women articulated several suggestions including the importance of physician input, using a balanced approach when making recommendations, and the value of sharing individual experiences.

Conclusions Older women with FI make several dietary modifications to manage their symptoms including limiting certain foods, changing methods of food preparation, and decreasing the amounts and frequency of meals. These strategies may be considered for inclusion in a diet modification plan that is culturally competent for older women with FI.

From the *Division of Urogynecology, Department of OB/GYN, University of Pennsylvania School of Medicine;

Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA;

Birmingham/Atlanta VA GRECC. Birmingham VA Medical Center;

§Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; and

Jefferson College of Population Health, Thomas Jefferson University. Philadelphia, PA.

Correspondence: Uduak U. Andy, 3400 Spruce St, Dulles, 5th floor, Philadelphia, PA 19104.

This study was supported by a grant from the National Institute on Aging (Grant Number R03-AG-053277 to PI: U.U.A.).

L.A.A. and R.F. contributed equally to this study.

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