What is the impact of fecal incontinence on quality of life?

PURPOSE: The objective of this study was to determine at what point fecal i ncontinence affects quality of life. METHODS: In 35 patients who had anteri or sphincter repair for fecal incontinence as a result of obstetric injury, continence evaluated by the Wexner score was compared with validated quali ty of life tests (Gastrointestinal Quality of Life index and Medical Outcom es Study Short-Form General Health Survey). The questionnaires were sent by mail. Thirty-two patients responded. The Wexner score (0-20) was correlate d with the Gastrointestinal Quality of Life Index and the Medical Outcomes Study Short-Form General Health Survey and matched with those of reference groups. RESULTS: The mean Wexner score vc as 8.8, corresponding with losing stools between once a week and once a month. The mean Gastrointestinal Qua lity of Life Index score was 105 (range, 48-136), which is significantly lo wer than the score found in a reference group of normal individuals. Medica l Outcomes Study Short-Form General Health Survey scores were significantly lower in all six dimensions compared with the reference group. A Wexner sc ore of 9 or higher was associated with a Gastrointestinal Quality of Life I ndex score of less than 105, which implies that patients were less mobile i n the community and were confined to their homes. A similar correlation was found between a Wexner score higher than 9 and the Medical Outcomes Study Short-Form General Health Survey. CONCLUSIONS: A Wexner score of 9 or highe r indicates a significant impairment of quality of life and can therefore b e used in decision making.