A controlled trial of an intervention to improve urinary and fecal incontinence and constipation

John F. Schnelle, Felix W. Leung, Satish Sanku Chander Rao, Linda Beuscher, Emmett Keeler, Jack W. Clift, Sandra Simmons

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objectives: To evaluate effects of a multicomponent intervention on fecal incontinence (FI) and urinary incontinence (UI) outcomes. Design: Randomized controlled trial. Setting: Six nursing homes (NHs). Participants: One hundred twelve NH residents. Intervention: Intervention subjects were offered toileting assistance, exercise, and choice of food and fluid snacks every 2 hours for 8 hours per day over 3 months. Measurements: Frequency of UI and FI and rate of appropriate toileting as determined by direct checks from research staff. Anorectal assessments were completed on a subset of 29 residents. Results: The intervention significantly increased physical activity, frequency of toileting, and food and fluid intake. UI improved (P=.049), as did frequency of bowel movements (P<.001) and percentage of bowel movements (P<.001) in the toilet. The frequency of FI did not change. Eighty-nine percent of subjects who underwent anorectal testing showed a dyssynergic voiding pattern, which could explain the lack of efficacy of this intervention program alone on FI. Conclusion: This multicomponent intervention significantly changed multiple risk factors associated with FI and increased bowel movements without decreasing FI. The dyssynergic voiding pattern and rectal hyposensitivity suggest that future interventions may have to be supplemented with bulking agents (fiber), biofeedback therapy, or both to improve bowel function.

Original languageEnglish (US)
Pages (from-to)1504-1511
Number of pages8
JournalJournal of the American Geriatrics Society
Volume58
Issue number8
DOIs
StatePublished - Aug 1 2010
Externally publishedYes

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Fecal Incontinence
Urinary Incontinence
Constipation
Nursing Homes
Snacks
Randomized Controlled Trials
Eating
Research

Keywords

  • constipation
  • fecal incontinence
  • urinary incontinence

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

A controlled trial of an intervention to improve urinary and fecal incontinence and constipation. / Schnelle, John F.; Leung, Felix W.; Rao, Satish Sanku Chander; Beuscher, Linda; Keeler, Emmett; Clift, Jack W.; Simmons, Sandra.

In: Journal of the American Geriatrics Society, Vol. 58, No. 8, 01.08.2010, p. 1504-1511.

Research output: Contribution to journalArticle

Schnelle, John F. ; Leung, Felix W. ; Rao, Satish Sanku Chander ; Beuscher, Linda ; Keeler, Emmett ; Clift, Jack W. ; Simmons, Sandra. / A controlled trial of an intervention to improve urinary and fecal incontinence and constipation. In: Journal of the American Geriatrics Society. 2010 ; Vol. 58, No. 8. pp. 1504-1511.
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