Fecal incontinence: does age matter? Characteristics of older vs. younger women presenting for treatment of fecal incontinence.

Purpose: The etiology of fecal incontinence is multifactorial. We hypothesize that women who seek treatment at different ages differ. We sought to determine which characteristics of women with fecal incontinence patients are associated with younger age at presentation.

Methods: We reviewed a database of 399 women with complete fecal incontinence evaluations from 2001 to 2006, selecting patients who were aged 49 and younger or aged 65 years and older, for a total of 246 patients. Data were obtained from self-report questionnaires on fecal incontinence frequency and associated symptoms, medical history, and results of anorectal physiology tests. Univariate and multivariate analyses were performed.

Results: The median ages of the two groups were 42 (range, 23-49) years and 72 (range, 65-89) years. Sphincter defects > 90 degrees and previous sphincteroplasty were associated with the younger age group. Previous hemorrhoid surgery and bilateral pudendal neuropathy were associated with the older age group. Younger women had more frequent incontinence to gas, mucus, and liquid stool.

Conclusions: In our cohort, fecal incontinence-related symptoms and medical conditions differed in older and younger women presenting with this condition. Younger women may be more likely to seek treatment for any degree of symptoms. The differing characteristics of fecal incontinence by age should be considered when developing a treatment strategy.