Impact of fecal incontinence on quality of life

Table 1 FIQL of patients attending CCs and UCs in North Queensland

Scale3	n1	Missing	Mean (range)2	SD	Median (IQR)
Scale 1: lifestyle	119	35	2.99 (1.0-4.0)	0.899	3.24 (2.22-3.80)
Scale 2: coping	130	24	2.36 (1.0-4.0)	0.884	2.23 (1.60-3.00)
Scale 3: depression	128	26	2.57 (1.0-4.0)	0.806	2.42 (1.95-3.33)
Scale 4: embarrassment	124	30	2.53 (1.0-4.0)	0.990	2.33 (1.67-3.58)

FIQL, Rockwood et al[22];

¹Patients who consented to participate in the 2003 and 2004 studies and answered yes to ever soiling with feces, n = 154;

²QOL scale of 1 represents very low functional status and 4 is not affected by FI;

³Scales calculated as per letter to the editor. Rockwood[26].

Table 2 Multiple linear regression identifying relationship between FIQL scales and clinic, duration, FI severity¹ in females [regression coefficient (95% CI)]

	Lifestyle	P	Coping	P	Depression	P	Embarrassment	P
CC	-0.582 (-0.938, -0.225)	0.002	-0.499 (-0.835, -0.162)	0.004	-0.365 (-0.685, -0.045)	0.026	-0.568 (-0.923, -0.214)	0.002
Duration (mo)	-0.002 (-0.004, 0.000)	0.042	-0.002 (-0.004, 0.000)	0.103	-0.002 (-0.004, 0.000)	0.041	-0.003 (-0.005, 0.000)	0.020
Severity (1-8)1	-0.159 (-0.241, -0.076)	< 0.001	-0.176 (-0.255, -0.097)	< 0.001	-0.143 (-0.216, -0.069)	< 0.001	-0.207 (-0.290, -0.124)	< 0.001

¹Fecal incontinence (FI) severity = soiling type × frequency, i.e. liquid (1), solid (1), both (2) × daily (4), weekly (3), monthly (2), less often (1). CC: Colorectal clinic.

Table 3 Association of descriptive FI with FIQL of patients attending CCs and UCs in North Queensland

Categorical variables	Scale 1: lifestyle1			Scale 2: coping1			Scale 3: depression1			Scale 4: embarrassment1
	n(missing)	Median (IQR)2	P value	n(missing)	Median (IQR)2	P value	n(missing)	Median (IQR)2	P value	n(missing)	Median (IQR)2	P value
Frequency of fecal soiling (seven cases not stated)
Daily	24 (1)	2.10 (1.33-2.91)	< 0.001a	24 (1)	1.33 (1.18-1.83)	< 0.001a	23 (2)	1.71 (1.37-2.29)	< 0.001a	23 (2)	1.46 (1.00-2.07)	< 0.001a
Weekly	31 (4)	3.10 (2.40-3.60)		32 (3)	2.26 (1.47-2.82)		30 (5)	2.54 (2.06-3.08)		30 (5)	2.33 (1.33-3.00)
Monthly	18 (4)	3.30 (2.60-3.70)		18 (4)	2.14 (1.94-2.82)		19 (3)	2.29 (1.77-3.38)		19 (3)	2.33 (2.00-3.33)
Less often	48 (17)	3.70 (2.85-4.00)		54 (11)	2.88 (2.15-3.57)		52 (13)	3.02 (2.19-3.66)		50 (15)	3.00 (2.33-4.00)
Type of fecal soiling (eight cases not stated)
Liquid	59 (16)	3.26 (2.50-3.80)	0.077a	64 (11)	2.44 (1.78-3.11)	0.024a	62 (13)	2.78 (2.14-3.57)	0.005a	62 (13)	2.67 (2.00-3.67)	0.003a
Solid	24 (7)	3.37 (2.60-3.93)		27 (4)	2.33 (1.63-3.22)		27 (4)	2.64 (2.09-3.50)		25 (6)	2.33 (1.83-3.67)
Both	35 (5)	3.00 (1.50-3.70)		38 (2)	2.00 (1.26-2.50)		37 (3)	2.19 (1.60-2.57)		36 (4)	2.00 (1.33-2.67)
Quantity of fecal soiling (four cases not stated)
Minimal soiling	65 (18)	3.60 (3.00-4.00)	< 0.001a	71 (12)	2.67 (2.17-3.40)	< 0.001a	69 (14)	2.80 (2.20-3.61)	0.001a	69 (14)	2.67 (2.00-3.67)	0.010a
Major soiling	41 (11)	3.00 (2.06-3.55)		46 (6)	2.06 (1.44-2.58)		45 (7)	2.27 (1.89-2.92)		43 (9)	2.32 (2.00-3.00)
Soiling outer clothes	8 (1)	2.12 (1.63-2.45)		8 (1)	1.28 (1.14-1.46)		8 (1)	2.00 (1.72-2.59)		7 (2)	1.67 (1.33-2.33)
Soiling furniture	5 (1)	1.30 (1.25-1.95)		5 (1)	1.00 (1.00-2.14)		5 (1)	1.37 (1.19-2.28)		5 (1)	1.00 (1.00-2.67)
Fecal urgency (four cases not stated)
Never	15 (10)	4.00 (3.30-4.00)	0.001a	16 (9)	3.40 (2.24-3.76)	< 0.001a	20 (5)	2.45 (2.19-3.40)	0.177a	17 (8)	2.67 (1.56-3.83)	0.507a
Sometimes	88 (21)	3.25 (2.22-3.70)		98 (11)	2.24 (1.60-2.96)		92 (17)	2.48 (1.88-3.37)		91 (18)	2.33 (2.00-3.33)
Always	15 (1)	2.30 (1.80-2.60)		15 (1)	1.50 (1.33-2.06)		15 (1)	2.24 (1.77-2.64)		15 (1)	2.00 (1.33-3.33)
Women only UC-ever	47 (11)	3.30 (2.70-3.80)	0.005b	52 (6)	2.44 (1.79-3.11)	0.002b	50 (8)	2.72 (2.08-3.56)	0.034b	49 (9)	2.67 (2.00-3.67)	0.003b
Women only CC-ever	38 (7)	2.45 (1.72-3.60)		42 (3)	1.86 (1.28-2.44)		39 (6)	2.24 (1.65-2.86)		39 (6)	2.00 (1.33-2.67)
Passive fecal soiling (seven cases not stated)
Never	38 (12)	3.40 (2.67-4.00)	0.086a	41 (9)	2.56 (1.97-3.42)	0.049a	43 (7)	3.05 (2.28-3.66)	0.008a	40 (10)	3.33 (2.33-4.00)	< 0.001a
Sometimes	63 (16)	3.10 (2.20-3.60)		69 (10)	2.17 (1.56-2.78)		65 (14)	2.23 (1.80-2.90)		64 (15)	2.00 (1.42-2.92)
Always	15 (3)	2.50 (1.70-3.90)		17 (1)	2.06 (1.39-3.20)		17 (1)	2.27 (1.90-3.39)		17 (1)	2.00 (1.00-2.96)
Women only UC-ever	36 (9)	3.30 (2.76-3.82)	0.040b	39 (6)	2.44 (1.78-3.22)	0.020b	39 (6)	2.48 (1.94-3.27)	0.181b	38 (7)	2.33 (1.92-3.00)	0.019b
Women only CC-ever	33 (7)	2.50 (1.61-3.60)		37 (3)	1.91 (1.28-2.44)		34 (6)	2.20 (1.70-2.86)		34 (6)	1.83 (1.33-2.67)

FIQL, Rockwood et al[22]; n: Number of participants in each category.

¹Scales calculated as per letter to the editor. Rockwood[26];

²QOL score of 1 represents very low functional status and 4 is not affected by FI.

^aKruskal-Wallis test;

^bMann-Whitney U test.

Table 4 Multiple linear regression identifying relationship between FIQL and components of FI severity

Components of FI severity	FIQL scales
	Lifestyle	Coping	Depression	Embarrassment
Frequency
Monthly	0.061	0.002	0.008	0.006
Weekly	0.241	0.846	0.531	0.595
Daily	< 0.001	0.012	0.023	0.021
Type
Solid	0.010	0.192	0.515	0.633
Both solid/liquid	0.254	0.085	0.007	0.014
Urgency
Sometimes	0.961	0.325	0.565	0.888
Always	0.106	0.023	0.554	0.636
Wears pads	0.209	0.022	0.488	0.107
Passive leakage
Sometimes	0.659	0.169	0.103	0.787
Always	0.626	0.485	0.252	0.007
Quantity of leakage
Major (Requires immediate underwear change)	0.001	< 0.001	0.004	0.096
Soiling of outer clothes	0.023	0.217	0.969	0.405
Soiling of furniture/bedding	0.578	0.781	0.381	0.662