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Pathophysiology of fecal incontinence in obese patients: A prospective case-matched study of 201 patients

Abstract : BackgroundObesity is an emerging risk factor for fecal incontinence (FI). The aim of this study was to characterize pathophysiologic mechanisms of FI in obese patients compared with non-obese patients in a prospective case-matched study. MethodsThe general characteristics and data of the anorectal manometry and endosonography of patients who were evaluated for FI at a single institution from 2005 to 2015 were prospectively assessed. Fecal incontinence was defined by a Cleveland Clinic Incontinence Score (CCIS) >4. Obesity was defined by a body mass index 30kg/m(2). Obese patients were case-matched with two age- and sex-matched non-obese patients. Key ResultsA total of 201 patients were included (67 obese matched with 134 non-obese). The CCIS, Knowles-Eccersley-Scott Symptom Constipation Score and quality of life score were comparable between obese and non-obese patients with FI. Factors significantly associated with obesity in FI patients were cholecystectomy (odds ratio [OR]=3.45 [1.19-10.32], P=.0230), irritable bowel syndrome - diarrhea (OR=2.94 [1.22-7.19], P=.0158), upper part of the anal canal resting pressure 22mmHg (OR=3.45 [1.45-8.76], P=.0045), maximum rectal tolerable volume 240mL (OR=3.14 [1.34-7.54], P=.0082), and abdominal pressure 28mmHg (OR=2.75 [1.13-7.33], P=.0248) by multivariate analysis. Conclusions & InferencesObese patients with FI had a comparable severity of FI to that of non-obese patients with FI. Regarding obesity in patients with FI, physicians should focus on stool consistency.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01577963
Contributor : Laurent Jonchère <>
Submitted on : Monday, August 28, 2017 - 3:06:21 PM
Last modification on : Sunday, October 25, 2020 - 7:06:25 AM

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C. Brochard, A. Venara, A. Bodère, A. Ropert, G. Bouguen, et al.. Pathophysiology of fecal incontinence in obese patients: A prospective case-matched study of 201 patients. Neurogastroenterology & Motility, Wiley, 2017, 29 (8), pp.e13051. ⟨10.1111/nmo.13051⟩. ⟨hal-01577963⟩

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