Editing Fecal incontinence (section)

== Epidemiology ==

FI is thought to be very common,<ref name="ASCRS core subjects FI" /> but much under-reported due to embarrassment. One study reported a prevalence of 2.2% in the general population.<ref name="ASCRS textbook" /> It affects people of all ages but is more common in older adults (but it should not be considered a normal part of aging).<ref name="Shah 2012">{{cite journal | vauthors = Shah BJ, Chokhavatia S, Rose S | title = Fecal incontinence in the elderly: FAQ | journal = The American Journal of Gastroenterology | volume = 107 | issue = 11 | pages = 1635–1646 | date = November 2012 | pmid = 22964553 | doi = 10.1038/ajg.2012.284 | s2cid = 2405543 }}</ref> Females are more likely to develop it than males (63% of those with FI over 30 may be female).<ref name="ASCRS core subjects FI" /> In 2014, the [[National Center for Health Statistics]] reported that one out of every six seniors in the U.S. who lived in their own homes or apartment had FI. Men and women were equally affected.<ref>{{cite news |url= http://newoldage.blogs.nytimes.com/2014/07/22/an-emotional-burden-rarely-discussed/ |title=An 'Emotional Burden' Rarely Discussed|newspaper=New York Times |author=Judith Graham|date=July 29, 2014|access-date=August 23, 2014}}</ref> 45–50% of people with FI have severe physical or mental disabilities.<ref name="ASCRS core subjects FI" /> People with dementia are four times more likely to have fecal incontinence compared to people of similar ages.<ref>{{Cite journal |date=21 June 2022 |title=Continence, dementia, and care that preserves dignity |url=https://evidence.nihr.ac.uk/themedreview/continence-dementia-and-care-that-preserves-dignity/ |journal=NIHR Evidence |doi=10.3310/nihrevidence_51255|s2cid=251785991 }}</ref><ref>{{cite journal | vauthors = Grant RL, Drennan VM, Rait G, Petersen I, Iliffe S | title = First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database | journal = PLOS Medicine | volume = 10 | issue = 8 | pages = e1001505 | date = August 2013 | pmid = 24015113 | pmc = 3754889 | doi = 10.1371/journal.pmed.1001505 | veditors = Prince MJ | doi-access = free }}</ref>

Risk factors include age, female gender, urinary incontinence, history of vaginal delivery (non-[[Caesarean section]] childbirth), obesity,<ref name="4th ICI" /> prior anorectal surgery, poor general health, and physical limitations. Combined urinary and fecal incontinence is sometimes termed double incontinence, and it is more likely to be present in those with urinary incontinence.<ref name="Lacima 2003">{{cite journal | vauthors = Lacima G, Pera M | title = Combined fecal and urinary incontinence: an update | journal = Current Opinion in Obstetrics & Gynecology | volume = 15 | issue = 5 | pages = 405–410 | date = October 2003 | pmid = 14501244 | doi = 10.1097/00001703-200310000-00009 | s2cid = 20587023 }}</ref>

Traditionally, FI was thought to be an insignificant complication of surgery, but it is now known that a variety of different procedures are associated with this possible complication, and sometimes at high levels. Examples are midline internal sphincterotomy (8% risk), lateral internal sphincterotomy, [[fistulectomy]], fistulotomy (18{{ndash}}52%), hemorrhoidectomy (33%), [[Ileo-anal pouch|ileo-anal reservoir reconstruction]]<!--correct page for operation??-->, lower anterior resection, total abdominal colectomy, [[ureterosigmoidostomy]],<ref name="4th ICI" /> and [[Anal fissure#Anal dilation|anal dilation]] (Lord's procedure, 0–50%).<ref name="Ommer 2008">{{cite journal | vauthors = Ommer A, Wenger FA, Rolfs T, Walz MK | title = Continence disorders after anal surgery--a relevant problem? | journal = International Journal of Colorectal Disease | volume = 23 | issue = 11 | pages = 1023–1031 | date = November 2008 | pmid = 18629515 | doi = 10.1007/s00384-008-0524-y | s2cid = 7247471 }}</ref> Some authors consider obstetric trauma to be the most common cause.<ref name="Rieger 1999">{{cite journal | vauthors = Rieger N, Wattchow D | title = The effect of vaginal delivery on anal function | journal = The Australian and New Zealand Journal of Surgery | volume = 69 | issue = 3 | pages = 172–177 | date = March 1999 | pmid = 10075354 | doi = 10.1046/j.1440-1622.1999.01517.x }}</ref>