Clinician Administered and Self-Report Survey Both Effective for Identifying Fecal Incontinence in Patients with Inflammatory Bowel Disease

Dig Dis Sci. 2021 Jun;66(6):2024-2031.doi: 10.1007/s10620-020-06418-9. Epub 2020 Jun 20.

Lesley Dibley 1 2, Ailsa Hart 3, Julie Duncan 4 5, Charles H Knowles 6, Sally Kerry 7, Doris Lanz 7, Vichithranie W Madurasinghe 7 8, Tiffany Wade 9, Helen Terry 10, Azmina Verjee 11, Mandy Fader 12, Christine Norton 9


Author information

  • 1Florence Nightingale Faculty of Nursing, Midwifery and Palliative, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK. L.B.Dibley@Greenwich.ac.uk.
  • 2Centre for Chronic Illness and Ageing, Institute for Lifecourse Development, School of Health Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich (Southwood Site), Rm G208, Grey Building, Avery Hill Road, Eltham, London, SE9 2 UG, UK. L.B.Dibley@Greenwich.ac.uk.
  • 3St Mark's Hospital (IBD Unit), Northwick Park Hospital, Watford Road, Harrow, Middlesex, HA1 3UJ, UK.
  • 4Department of Gastroenterology, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
  • 5Takeda UK, London, UK.
  • 6Blizard Institute, Barts and The London School of Medicine and Dentistry, The Blizard Building, 4 Newark Street, London, E1 2AT, UK.
  • 7Pragmatic Clinical Trials Unit (PCTU), Centre for Primary Care and Public Health, Queen Mary University, London (Whitechapel Campus), Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
  • 8University of Oxford, Oxford, UK.
  • 9Florence Nightingale Faculty of Nursing, Midwifery and Palliative, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK.
  • 10Crohn's and Colitis UK, 1 Bishops Square, Hatfield Business Park, Hatfield, AL10 9NE, UK.
  • 11Patient and Public Involvement Team Lead, London, UK.
  • 12School of Health Sciences, University of Southampton, Southampton, UK.


Objectives: To test two methods for reporting of fecal incontinence (FI) in people with inflammatory bowel disease.

Methods: Consecutive patients from IBD clinics in six UK hospitals completed a short three-item case-finding survey about FI; they either completed the survey themselves or were asked the same questions face to face by a clinician.

Results: Of 1336 eligible patients with complete data (48% male; mean 43 years; 55% Crohn's disease, 41% ulcerative colitis), 772 were asked about FI face to face, and 564 self-completed the survey: FI was reported in 63% and 56%, respectively (p = 0.012). In regression analyses, those aged 51-60, having Crohn's disease and higher disease activity, were more likely to report FI. Of all respondents, 38.7% were interested in receiving help for their incontinence.

Conclusions: Fecal incontinence affects the majority of people with IBD. Although more patients reported fecal incontinence when asked face to face than self-reported, routine screening by either method in clinical practice is recommended. Over one-third of patients with IBD want help for bowel control problems.

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