Outcomes of combination treatment of fecal incontinence in women

OBJECTIVE: To describe how women with fecal incontinence (FI) respond to combined pharmacologic therapy and pelvic floor muscle exercises (PFME). STUDY DESIGN: Validated questionnaires (Fecal Incontinence Severity Index and Modified Manchester Health Questionnaire) were mailed to 80 women who received combined therapy for FI and had complete baseline assessments. Regression models were constructed to identify predictors of change in questionnaire scores. RESULTS: Response rate was 69%. Mean age was 59 +/- 12 years. All women were taught PFME with digital palpation, and 87% of the women received medications. FI severity scores and quality-of-life (QOL) improved from baseline to follow-up (P < .001 and P = .02, respectively). A fair/normal external anal sphincter (EAS) contraction resulted in greater improvements in FI severity (13 points, P = .006) and QOL scores (22 points, P < .001). CONCLUSION: FI severity and QOL improved after combination therapies, and a fair/normal EAS contraction predicted greater improvement.