A Controlled Trial of an Intervention to Improve Urinary and Fecal Incontinence and Constipation
- 3 August 2010
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 58 (8), 1504-1511
- https://doi.org/10.1111/j.1532-5415.2010.02978.x
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.This publication has 38 references indexed in Scilit:
- Prevention of Unintentional Weight Loss in Nursing Home Residents: A Controlled Trial of Feeding AssistanceJournal of the American Geriatrics Society, 2008
- Intervention with Dietary Fiber to Treat Constipation and Reduce Laxative Use in Residents of Nursing HomesAnnals of Nutrition and Metabolism, 2008
- Constipation in Long-Term CareJournal of the American Medical Directors Association, 2007
- Use of Laxatives among Older Nursing Home Residents in Helsinki, FinlandDrugs & Aging, 2007
- Efficacy of an Herbal Dietary Supplement (Smooth Move) in the Management of Constipation in Nursing Home Residents: A Randomized, Double-Blind, Placebo-Controlled StudyJournal of the American Medical Directors Association, 2006
- Management of Constipation in Residents With Dementia: Sorbitol Effectiveness and CostJournal of the American Medical Directors Association, 2005
- Investigation of the utility of colorectal function tests and Rome II criteria in dyssynergic defecation (Anismus)Neurogastroenterology & Motility, 2004
- The Minimum Data Set Pressure Ulcer Indicator: Does It Reflect Differences in Care Processes Related to Pressure Ulcer Prevention and Treatment in Nursing Homes?Journal of the American Geriatrics Society, 2003
- Fecal incontinence in Wisconsin nursing homesDiseases of the Colon & Rectum, 1998
- Liquid stool incontinence with severe urgency: anorectal function and effective biofeedback treatment.Gut, 1993