Depending upon the definition and frequency of faecal incontinence, and how proactively the diagnosis is sought, the prevalence varies from 1% to 10%.[1]Perry S, Shaw C, McGrother C, et al; Leicestershire MRC Incontinence Study Team. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut. 2002 Apr;50(4):480-4.
https://gut.bmj.com/content/50/4/480
http://www.ncbi.nlm.nih.gov/pubmed/11889066?tool=bestpractice.com
[3]Nelson R, Norton N, Cautley E, et al. Community-based prevalence of anal incontinence. JAMA. 1995 Aug 16;274(7):559-61.
http://www.ncbi.nlm.nih.gov/pubmed/7629985?tool=bestpractice.com
[4]Ribas Y, Coll M, Espina A, et al. Initiative to improve detection of faecal incontinence in primary care: the GIFT Project. Fam Pract. 2017 Apr 1;34(2):175-9.
https://academic.oup.com/fampra/article/34/2/175/2992964
http://www.ncbi.nlm.nih.gov/pubmed/28201584?tool=bestpractice.com
However, when comparable methodologies and definitions are used, studies produce remarkably similar prevalence rates in different community populations (around 8.3% to 8.4% for face-to-face or telephone interviews, and 11.2% to 12.4% for postal surveys).[5]Sharma A, Yuan L, Marshall RJ, et al. Systematic review of the prevalence of faecal incontinence. Br J Surg. 2016 Nov;103(12):1589-97.
http://www.ncbi.nlm.nih.gov/pubmed/27704537?tool=bestpractice.com
The prevalence is higher in nursing home residents, parous women, patients with cognitive impairment or neurological disorders, and older people.[1]Perry S, Shaw C, McGrother C, et al; Leicestershire MRC Incontinence Study Team. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut. 2002 Apr;50(4):480-4.
https://gut.bmj.com/content/50/4/480
http://www.ncbi.nlm.nih.gov/pubmed/11889066?tool=bestpractice.com
[3]Nelson R, Norton N, Cautley E, et al. Community-based prevalence of anal incontinence. JAMA. 1995 Aug 16;274(7):559-61.
http://www.ncbi.nlm.nih.gov/pubmed/7629985?tool=bestpractice.com
In the institutionalised population, it may be as high as 50%.[6]Nelson RL. Epidemiology of fecal incontinence. Gastroenterology. 2004 Jan;126(1 Suppl 1):S3-7.
http://www.ncbi.nlm.nih.gov/pubmed/14978632?tool=bestpractice.com
Outside institutions it remains a largely hidden problem, due to the social stigma attached. As obstetric injury (either direct muscle damage or neuropathy due to pelvic nerve stretching during delivery) is a common cause, patients are often female. The general pelvic muscle/tissue deterioration that occurs with age results in an older population being more commonly affected. Cognitive dysfunction, general disability, and the tendency to ignore bowel habits resulting in constipation and faecal impaction also contribute to the higher incidence in the older, frailer age groups, particularly those in institutions. Surgery to the pelvic floor or the intestine that results in a reduction in length or compliance of the gut may affect some patients.
In the US, faecal incontinence remains an important social and economic problem, with an average cost of $4110 per patient annually.[7]Xu X, Menees SB, Zochowski MK, et al. Economic cost of fecal incontinence. Dis Colon Rectum. 2012 May;55(5):586-98.
http://www.ncbi.nlm.nih.gov/pubmed/22513438?tool=bestpractice.com