Anal Intercourse and Fecal Incontinence: Evidence from the 2009-2010 National Health and Nutrition Examination Survey
OBJECTIVES:
The
aim of this study was to assess the prevalence and associations between anal
intercourse and fecal incontinence.
METHODS:
Analyses
were based on data from 6,150 adults (≥20 years) from the 2009-2010 cycle of
the National Health and Nutrition Examination Surveys. Fecal incontinence was
defined as the loss of liquid, solid, or mucus stool occurring at least monthly
on a validated questionnaire. A gender-specific sexual behavior questionnaire
assessed any anal intercourse via an audio computer-assisted personal
interview. Co-variables included: age, race, education, poverty income ratio,
body mass index, chronic illnesses, depression, loose stool consistency
(Bristol Stool Scale types 6 or 7), and reproductive variables in women.
Prevalence estimates and prevalence odds ratios (PORs) were analyzed in
adjusted multivariable models using appropriate sampling weights.
RESULTS:
Overall,
4,170 adults aged 20-69 years (2,070 women and 2,100 men) completed sexual behavior
questionnaires and responded to fecal incontinence questions. Anal intercourse
was higher among women (37.3%) than men (4.5%), P<0.001. Fecal incontinence
rates were higher among women (9.9 vs. 7.4%, P=0.05) and men (11.6 vs. 5.3%,
P=0.03) reporting anal intercourse compared with those not reporting anal
intercourse. After multivariable adjustment for other factors associated with
fecal incontinence, anal intercourse remained a predictor of fecal incontinence
among women (POR: 1.5; 95% confidence interval (CI): 1.0-2.0) and men (POR:
2.8; 95% CI: 1.6-5.0).
CONCLUSIONS:
The
findings support the assessment of anal intercourse as a factor contributing to
fecal incontinence in adults, especially among men.
- 1Birmingham Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama, USA.
- 2Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Atlanta, Georgia, USA.
- 3Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, UAB Center for Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
- 4Department of Obstetrics and Gynecology, Division of Urogynecology, University of New Mexico, Albuquerque, New Mexico, USA.
- 5Department of Medicine, Division of General Medicine and Geriatrics, Emory University, Atlanta, Georgia, USA.
- Am J Gastroenterol. 2016 Jan 12. doi: 10.1038/ajg.2015.419
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