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

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

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


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
Issue number8
StatePublished - Aug 2010
Externally publishedYes


  • constipation
  • fecal incontinence
  • urinary incontinence

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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