Targets for interventions for faecal incontinence in inflammatory bowel disease: a systematic review

Hannah Proudfoot, Christine Norton, Micol Artom, Eve Didymus, Sylwia Kubasiewicz, Bernadette Khoshaba

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)
264 Downloads (Pure)

Abstract

OBJECTIVE: Prevalence of faecal incontinence is greater in patients with inflammatory bowel disease than in the general population. It is a major concern for patients with inflammatory bowel disease, even when disease is in remission. It is underreported and negatively affects quality of life. We explored the evidence on the associations of faecal incontinence in inflammatory bowel disease and the effectiveness of interventions.

MATERIAL AND METHODS: Databases searched in October 2017: Web of Science, MEDLINE, EMBASE, CINAHL, PsycINFO, British Nursing Index and Scopus. Manual search of reference lists was also conducted. Four researchers independently screened references and extracted data.

RESULTS: Eighteen studies were included in the review (14 on associations, four on interventions). The presence of faecal incontinence was reported as 12.7-76% among 5924 participants, varying in definitions adopted and populations studied. Factors associated with faecal incontinence included disease activity, loose stool, female gender, childbirth, previous surgery, anal sphincter weakness or fatigability, anxiety and depression. The cross-sectional design of studies means causation cannot be inferred. Interventions included surgery (sphincter repair and sacral nerve stimulation) and tibial nerve stimulation which each improved faecal incontinence. However, the four intervention studies were small (34 participants in total) and uncontrolled.

CONCLUSION: There is a high prevalence of faecal incontinence in inflammatory bowel disease associated with various sociodemographic, clinical and psychosocial factors which could be targeted in future interventions. Future intervention studies with control groups, targeting likely underlying causes such as disease activity, loose stool, psychological factors and anal sphincter function, are needed.

Original languageEnglish
Pages (from-to)1476-1483
Number of pages8
JournalScandinavian Journal of Gastroenterology
Volume53
Issue number12
DOIs
Publication statusPublished - 22 Jan 2019

Keywords

  • Inflammatory bowel disease
  • faecal incontinence
  • interventions
  • systematic review

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