Abstract
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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Acknowledgments
The team acknowledges the assistance of Irene Simmons, the original project coordinator for this study.
Funding
This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0613-31033). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
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Christine Norton (Chief Investigator) conceived the study. Christine Norton, Lesley Dibley, Julie Duncan, Ailsa Hart, Charles Knowles, Helen Terry, Azmina Verjee and Sally Kerry designed the study and developed the funding application. Lesley Dibley (Project Manager), was responsible for set up and oversight of participating sites, ethics applications, and qualitative analysis. Doris Lanz: was project coordinator at the Pragmatic Clinical Trials Unit. Sally Kerry had oversight of statistical analysis. Vichithranie Madurasinghe reviewed the statistical analysis plan and conducted the data analysis. Tiffany Wade conducted and analyzed qualitative interviews with patient participants, clinicians delivering the intervention, and with project staff. Azmina Verjee led the patient and Public Involvement team. Mandy Fader was Chair of the steering group, responsible for study review and monitoring. All authors contributed to manuscript writing and/or revising of drafts.
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Lesley Dibley has received speaker fees from Janssen, AbbVie, and Eli-Lilly, and consultancy fees from GL Assessments and Crohn’s & Colitis UK. Ailsa Hart has served as consultant, advisory board member or speaker for AbbVie, Atlantic, Bristol-Myers Squibb, Celltrion, Falk, Ferring, Janssen, MSD, Napp Pharmaceuticals, Pfizer, Pharmacosmos, Shire, and Takeda. She also serves on the Global Steering Committee for Genentech. Julie Duncan has received speaker fees from Warner Chilcott, Dr Falk pharma, Abbvie, Janssen, Takeda, MSD while an IBD Nurse Manager at Guy’s & St Thomas’s Hospitals Trust. She has been fully employed by Takeda UK Ltd since 2018. Charles Knowles has received speaker fees from, and acted as consultant for, Medtronic. Christine Norton has received speaker fees from Ferring, Takeda, and Tillotts Pharma. Mandy Fader, Sally Kerry, Doris Lanz, Vichithranie Madurasinghe, Tiffany Wade, Helen Terry, and Azmina Verjee have no conflicts of interest to declare.
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Dibley, L., Hart, A., Duncan, J. et al. Clinician Administered and Self-Report Survey Both Effective for Identifying Fecal Incontinence in Patients with Inflammatory Bowel Disease. Dig Dis Sci 66, 2024–2031 (2021). https://doi.org/10.1007/s10620-020-06418-9
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DOI: https://doi.org/10.1007/s10620-020-06418-9