Impact of faecal incontinence severity on health domains

Objective: Faecal incontinence is a problem that can have a major impact on the quality of life of those affected. Our aim was to relate the severity of faecal incontinence to the impact on several general health domains. Methods: Patients from a prospective diagnostic cohort study, performed in 16 medical centres in the Netherlands, were invited to the study. The severity of incontinence was determined with the Vaizey score, which ranges from 0 (continent) to 24 (totally incontinent). Based on their Vaizey score, patients were assigned to one of five severity categories. All patients completed the EuroQol-5D instrument, which evaluates the existence of problems on five health domains: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Results: Data from 259 consecutive patients (25 mate) could be analysed. Their mean age was 59 years (SD +/- 12). The mean duration of faecal incontinence was 8.1 years (SD +/- 8). The proportion of patients reporting problems rose significantly with increasing severity of faecal incontinence in the domains of usual activities (ranging from 36% in the least severe group to 71% in the most severe group (P < 0.001)), pain/discomfort (ranging from 35% to 60%; P = 0.025), and anxiety/depression (ranging from 23% to 49%; P = 0.037). No significant trends could be observed in the domains of mobility and self-care. Conclusion: There exists a significant relation between severity of incontinence and frequency of reported problems in the domains of usual activities, pain/discomfort and anxiety/depression.