Association Between Resolution of Constipation and Reduced Incidence of Fecal Incontinence: A Population‐Based Longitudinal Study

AIM: Few studies have evaluated the impact of constipation on future fecal incontinence, and none have examined whether constipation resolution reduces the incidence of fecal incontinence. We investigated the association between the resolution of constipation and the incidence of fecal incontinence. METHODS: This longitudinal study included independent, community-dwelling older adults in Japan aged ≥ 75 years. Constipation and fecal incontinence were measured using a self-administered questionnaire at baseline and at the 1-year follow-up. The 2233 eligible participants without fecal incontinence at baseline were divided into a constipation group (n = 917) and a non-constipation group (n = 1316). The constipation group was further categorized into a resolved constipation group (n = 221) and a sustained constipation group (n = 642), based on whether or not they had constipation at follow-up. Logistic regression models were used to evaluate the odds ratio (OR) and 95% confidence intervals (95% CIs) for incident fecal incontinence while adjusting for potential confounders. RESULTS: Fecal incontinence was developed in 106 participants (11.6%) in the constipation group and 89 participants (6.8%) in the non-constipation group. Constipation was associated with a higher incidence of fecal incontinence (multivariable-adjusted OR: 1.42 [95% CI: 1.02-2.00]). Furthermore, fecal incontinence occurred in nine participants (4.1%) in the resolved constipation group and in 72 participants (11.2%) in the sustained constipation group. Resolution of constipation was associated with the reduction in fecal incontinence (multivariable-adjusted OR: 0.35 [95% CI: 0.17-0.73]). CONCLUSIONS: Incidence of fecal incontinence was more common in participants with constipation, and the resolution of constipation was associated with the reduction in fecal incontinence. Constipation management could reduce the risk of fecal incontinence.