A new questionnaire for constipation and faecal incontinence


Dr A. E. Bharucha, Clinical and Enteric Neuroscience Translational and Epidemiological Research Program (CENTER), Mayo Clinic, 200 First St S.W., Rochester, MN 55905, USA.
E-mail: bharucha.adil@mayo.edu


Background : The prevalence, severity and risk factors of faecal incontinence in women in the community are incompletely characterized.

Aim : To develop and validate a self-report questionnaire (faecal incontinence and constipation assessment) to address these issues.

Method : Eighty-three women completed the instrument; 20 randomly selected patients answered the faecal incontinence and constipation assessment again 6 weeks later. A gastroenterologist also completed the faecal incontinence and constipation assessment in all 83 subjects after a detailed clinical assessment. Concurrent validity was evaluated by comparing the patient's self-report to a doctor interview for every question. Reproducibility was evaluated by a test–retest approach for every question. The severity of faecal incontinence was rated by incorporating the frequency and type of faecal incontinence, rectal urgency and use of sanitary devices.

Results : The questionnaire was well-understood. Reproducibility [median κ statistic, 0.80 (interquartile range: 0.66–0.90)]; and concurrent validity [0.59 (0.47–0.67)] were acceptable. For the index question on faecal incontinence, the κ for reproducibility and concurrent validity was 0.90 and 0.95, respectively. The faecal incontinence severity score was also valid (κ = 0.5).

Conclusion : The faecal incontinence and constipation assessment has excellent reproducibility and reasonable validity for assessing the presence, risk factors and severity of faecal incontinence and associated bowel disorders in women when compared against clinical assessment.