Purpose
Despite frequent occurrence, functional defecation disorders and related conditions have been infrequently reported in population studies. This study was designed to assess symptoms, lifestyle-behavioral changes, and medical care seeking related to functional defecation disorders in alarge household community survey.
Methods
A large household community survey was conducted in 10,000 individuals aged 15 years or older. A mailed questionnaire was used to assess ten common anorectal complaints; frequency, association, impact on quality of life, and medical care seeking were quantified.
Results
Evaluation was obtained in 7,196 patients (3,455 males). During the previous 12-month period, 2,097 patients (29.1 percent) experienced functional defecation disorders: outlet constipation and fecal incontinence were reported in 22.4 and 16.8 percent respectively. Compared with patients with no anorectal complaint, patients with functional defecation disorders had a different gender status (females, 63.3 vs. 47.6 percent; P < 0.01). Based on symptom severity, functional defecation disorders were perceived as the main anorectal complaint in 1,192 patients. In this group, emptying difficulties, unsatisfied defecation, gas, and fecal incontinence occurred at least once per month in 71.6, 56.1, 77.9, and 49 percent respectively: 66.6 percent with outlet constipation and 85.6 percent with incontinence revealed impairment in quality of life. Incontinent patients more frequently avoided medical care than those complaining of outlet constipation (67.4 vs. 46.4 percent; P < 0.01).
Conclusions
Functional defecation disorders concerns at least one of four French individuals. Outlet constipation and fecal incontinence frequently occur in association. Despite a low rate of patients seeking care, symptoms often are severe and related to quality of life impairment.
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Acknowledgments
The authors thank Richard Medeiros, M.D., Medical Editor of Rouen University Hospital, Rouen, France, for assistance, the Groupe de Recherche EnProctologie for validation of the questionnaire, Taylor Nelson Sofres, which organized both mailing and analyses of returned questionnaires, L. Abramowitz, M.D., J. Cittee, M.D., G. Delmas, I. Etienney, M.D., A. Martin, M. Murino, M.D., E. Nuris, T. Puy Montbrun, M.D., Y. Panis, M.D., Ph.D., O. Peixoto, M.D., P. Périé, S. Roquet, and I. Sobhani, M.D., Ph.D.
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Supported by Beaufour Ipsen pharma (rue Erlanger Paris France) in its financial aspect and by the Société Nationale Française de ColoProctologie (Institut Mutualiste Montsouris, Boulevard Jourdan, Paris, France) in its methodological aspect.
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Siproudhis, L., Pigot, F., Godeberge, P. et al. Defecation Disorders: A French Population Survey. Dis Colon Rectum 49, 219–227 (2006). https://doi.org/10.1007/s10350-005-0249-8
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DOI: https://doi.org/10.1007/s10350-005-0249-8