Abstract

Risk Factors for Fecal Urgency Among Individuals With and Without Diarrhea, Based on Data from the National Health and Nutrition Examination Survey

Rangan V1, Mitsuhashi S1, Singh P1, Ballou S1, Hirsch W1, Sommers T1, Nee J1, Iturrino J1, Lembo A2. Clin Gastroenterol Hepatol. 2018 Feb 20. pii: S1542-3565(18)30165-4. doi: 10.1016/j.cgh.2018.02.020. [Epub ahead of print]
 
     

Author information

1 Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.

2 Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. Electronic address: alembo@bidmc.harvard.edu.

Abstract

BACKGROUND & AIMS:

Fecal urgency is a common symptom among patients with gastrointestinal disorders, but can also occur in healthy individuals with normal bowel habits. There have been few studies of fecal urgency in the general population. We performed a cross-sectional analysis of data from the National Health and Nurition Examination Survey (NHANES) to analyze the prevalence of and risk factors for this symptom.

METHODS:

We analyzed data from 4,676 persons who completed the Bowel Health Questionnaire from the NHANES, from 2009 through 2010. The NHANES sampled a nationally representative group of adults in the United States and provides information on demographics, medical comorbidities, and dietary habits of survey participants. The Bowel Health Questionnaire provided additional information about bowel symptoms such as urgency, incontinence, constipation, and diarrhea. We identified individuals with fecal urgency and calculated differences in fecal urgency among subgroups using χ2 analysis. We used logistic regression to identify factors associated with urgency.

RESULTS:

In our study population, the prevalence of fecal urgency was 3.3%; 29.5% of individuals with fecalurgency had diarrhea. The prevalence of fecal urgency was significantly higher in individuals who had diarrhea (14.8%) than in individuals without diarrhea (3.1%). Older age, female sex, poverty, urinary urge incontinence, diarrhea, and increased stool frequency were all associated with fecal urgency on multivariable analysis. Decreased fiber intake and increased carbohydrate intake were associated with urgency among individuals with diarrhea.

CONCLUSIONS:

In an analysis of data from 4676 individuals who completed a Bowel Health Questionnaire from the NHANES, we found a significantly higher proportion of individuals with diarrhea to have fecal urgency. However, most individuals with fecal urgency do not have diarrhea. Factors associated with fecal urgency vary among individuals with and without diarrhea.

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