Prevalence of Anal Incontinence in a Population of Healthcare Workers

Abstract Background Anal incontinence is now recognized as a major health issue due to its economic burden and impact on quality of life. However, the true prevalence of this condition remains a matter of debate. Aims Our aim was to evaluate the prevalence of anal incontinence among the collaborators of a tertiary hospital. Methods An anonymous questionnaire was sent to the collaborators of a tertiary hospital. Jorge-Wexner and LARS scores and questions related to different definitions of anal and stool incontinence were evaluated. Demographic characteristics of the participants along with specific medical history were also collected. Results Among the 14279 collaborators, 2532 participants filled the questionnaire (17.7%). This sample was representative of the total hospital staff regarding age, gender and occupation. Twenty-nine percent of the participants reported occasional episodes of anal incontinence (more than once a month but less than once a week). The Jorge-Wexner score was ≥ 3 in 20.9% of the participants and 15% reported rare episodes of stool incontinence. However, only 2.3% fulfilled the strict Rome IV criteria for stool incontinence. A difference between women and men regarding the presence of anal incontinence was found (32.2% versus 21% p <0.001) but was not statistically significant for Rome IV criteria. In women, vaginal delivery was not associated with anal incontinence in univariate and multivariate analysis or with Rome IV criteria after adjustment. On the other hand, diabetes was strongly associated with Rome IV criteria (OR: 3.3, 95% CI: 1.09-10.08, p= 0.035). History of proctological procedure was also significantly and strongly associated with anal incontinence and Rome IV criteria (OR: 4, 95% CI: 1.86-8.6, p<0.001). Conclusions Prevalence of anal incontinence was higher than expected in an active population. We also demonstrated that the association between childbirth and anal incontinence was less important than expected.