Clinical Gastroenterology and Hepatology 2014;12:636643

Prevalence, Trends, and Risk Factors for Fecal Incontinence

in United States Adults, 20052010
Ivo Ditah,* Pardha Devaki, Henry N. Luma, Chobufo Ditah, Basile Njei,k Charles Jaiyeoba,
Augustine Salami,# Calistus Ditah,** Oforbuike Ewelukwa, and Lawrence Szarka*,

*Department of Medicine, Division of Gastroenterology and Hepatology, and Clinical Enteric Neurosciences Translational and
Epidemiology Research Program, Mayo Clinic, Rochester, Minnesota; Department of Medicine, Wayne State University,
Detroit, Michigan; Department of Medicine, Hopital General Douala, Douala, Cameroon; kDepartment of Medicine, University
of Connecticut School of Medicine, Farmington, Connecticut; Department of Medicine, St Mary Mercy Hospital, Livonia,
Michigan; #Department of Medicine, Department of Gastroenterology, Henry Ford Hospital, Detroit, Michigan; **Department of
Medicine, University of Michigan Medical School, Ann Arbor, Michigan; and Department of Medicine, Wright University,
Dayton, Ohio

BACKGROUND & AIMS: We investigated the prevalence of and trends and risk factors for fecal incontinence (FI) in the
United States among non-institutionalized adults from 2005 to 2010.

METHODS: We analyzed data from 14,759 participants in the U.S. National Health and Nutrition Exami-
nation Survey (49% women, 20 years or older) from 2005 to 2010 (the FI Severity Index was
added in 20052006). FI was dened as accidental leakage of solid or liquid stool or mucus at
least once in preceding month. Sampling weights were used to obtain estimates for the national
population. Logistic regression was used to identify risk factors for FI.

RESULTS: The prevalence of FI among non-institutionalized U.S. adults was 8.39% (95% condence in-
terval, 7.769.05). It was stable throughout the study period: 8.26% in 20052006, 8.48% in
20072008, and 8.41% in 20092010. FI resulted in release of liquid stool in most cases
(6.16%). Prevalence increased with age from 2.91% among 20- to 29-year-old participants to
16.16% (14.15%18.39%) among participants 70 years and older. Independent risk factors for
FI included older age, diabetes mellitus, urinary incontinence, frequent and loose stools, and
multiple chronic illnesses. FI was more common among women only when they had urinary
incontinence.

CONCLUSIONS: FI is a common problem among non-institutionalized U.S. adults. Its prevalence remained stable
from 20052010. Diabetes mellitus and chronic diarrhea are modiable risk factors. Future
studies on risk factors for FI should assess for presence of urinary incontinence.

Keywords: NHANES; Fecal Incontinence; Prevalence; Trends; Risk Factors.

ecal incontinence (FI) is the recurrent, involuntary
F passage of fecal matter (solid, liquid, or mucus) or
the inability to control the discharge of bowel con-
tents.13 It has socially devastating effects including poor
self-image, social isolation, and poor quality of life.4,5 It can
lead to depression, anxiety, and loss of employment.6,7 The
average total annual direct cost of FI in the United States is
estimated at $17,166 per person.6,7 It is one of the leading
causes of referral to nursing homes.4,810 The prevalence
of FI in the United States is reported to range from 2.2%
to 24%, with most estimates ranging from 7% to
12%.2,3,8,11 This variation is largely due to differences in
the denition of FI, study populations, and survey
methods.1,2,9
A majority of the data on FI comes from specic
subgroups of the population, notably referral population
and women.1,2,5,9,12,13 Most patients with FI do not
report these symptoms to their care providers for fear
of embarrassment.2,14 In 2005, the Pelvic Floor
Disorders Network submitted a validated FI severity
scale for inclusion in the National Health and Nutrition
Evaluation Survey (NHANES). The rst national
prevalence of FI was reported in 2009.3 These
estimates were limited by small number of participants.
Abbreviations used in this paper: CI, condence interval; FI, fecal incon-
tinence; NHANES, National Health and Nutrition Evaluation Survey; UI,
urinary incontinence.
2014 by the AGA Institute
1542-3565/$36.00
http://dx.doi.org/10.1016/j.cgh.2013.07.020
April 2014
From a public health perspective, the burden of FI on
individuals, families, and society cannot be under-
estimated. FI is projected to become a major challenge as
the proportion of the elderly increases in the general
population. Age remains the most consistent risk factor for
FI.1,3,8,15 The prevalence of FI among U.S. adults rose from
2.6% in 20- to 29-year-olds to 15.3% in adults 70 years
and older.3 Other factors including gender, race, urinary
incontinence (UI), body mass index, and diabetes have
been inconsistently associated with FI.2,3,1517 The study
by Whitehead et al3 included only 4308 individuals. Our
study involved 14,759 participants, making it the largest
ever population-based study on FI in the United States.
Our study involved 3 NHANES cycles, allowing for the
assessment of FI trends.
To date, there are no data on the trends of FI in the
United States. We hypothesized that because of the
changing age distribution of the U.S. population, the
prevalence of FI is almost certainly on the increase. The
NHANES has collected and reported data on FI from
2005 through 2010. This represents the largest data set
on FI and allows for calculation of robust estimates. The
aims of this study were to (1) estimate the prevalence of
FI, (2) analyze trends in FI, and (3) identify independent
risk factors for FI among U.S. adults.
Methods
The NHANES program consists of annual cross-
sectional, national health surveys conducted by the
National Center for Health Statistics, Centers for Disease
Control and Prevention. Demographic, socioeconomic,
and health interview data are collected in the home,
followed by physical examinations, interviews, and lab-
oratory assessments in mobile examination centers.
The detailed procedural methods pertaining to data
on FI have been previously published.3 The NHANES
20052010 data were combined to provide the de-
nominator for this study. The bowel health question-
naire includes questions from the Fecal Incontinence
Severity Index,18 which asks about the frequency of
accidental bowel leakage during the past month
separately for gas, mucus, liquid, and solid stool. Fre-
quency is assessed as 2 or more times a day, once a
day, 2 or more times a week, once a week, 13 times a
month, or never. For this study, FI was dened as any
involuntary loss of mucus, liquid, or solid stool in the
last 30 days. The bowel health questionnaire also
asked survey participants how often they usually have
bowel movements. For data analysis, their responses
were merged into 3 ranges: <3/wk, 321/wk, and
>21/wk.
The Bristol Stool Scale19 was used to determine
the participants usual stool consistency.20,21 For the
NHANES survey, participants were asked, What is
your usual or most common stool type? For this
study, we pooled stool type ratings 1 and 2 (hard and
Current Epidemiology of FI in the US 637
lumpy), ratings 35 (normal consistencies), and ratings
6 and 7 (mushy and watery).
Table 1 summarizes denitions of the various factors
included in the study.
Statistical Analysis
All estimates and measures of association were
derived by using the sampling weights provided by the
National Center for Health Statistics. These weights
consider unequal probabilities of selection resulting from
sample design, nonresponse, and planned oversampling
of the elderly, non-Hispanic black, and Mexican-American
populations.
The analysis was limited to adults 20 years and older.
Individuals with missing questionnaire items or who
refused to answer the FI questions were excluded from
the analysis. Stata program (Stata Corporation, College
Station, TX) was used to calculate prevalence estimates
and their 95% condence intervals (CIs). The examina-
tion sample weights adjust for unequal probabilities of
selection and nonresponse and are post-stratied to
population control totals for each sampling subdomain.
Estimates with relative standard errors greater than
30% are identied as statistically unreliable. Prevalence
was stratied by age, gender, and stool type. Time trends
are presented by age and gender. The results are shown
on bar charts and tables. First, age-adjusted bivariate
analyses were performed. Only factors that reached a
signicance limit of 0.10 in this analysis were included in
the multivariate analysis. The model was built in a for-
ward manner by adding one variable at a time. Interac-
tion between UI, gender, and age to explore for effect
modication was also performed. The Pearson c2 test
with a signicance limit of 0.05 was used to identify risk
factors for FI.
Results
Survey Response
Overall, 23,198 participants 20 years and older were
invited to participate in the NHANES household survey
during the 5-year period. Of these, 16,539 individuals
(71.3%) responded to the invitation and completed the
survey. Unfortunately, 1776 of the respondents (10.7%)
did not complete the health examination components that
included the bowel health questionnaire. Four partici-
pants (0.03%) specically refused to complete the FI
section of the questionnaire. For this study, only the
14,759 participants who completed the FI questionnaire
have been included in the analysis. These participants
were distributed as follows: 4308 (29.2%) in 20052006,
5 174 (35.1%) in 20072008, and 5277 (35.8%) in
20092010. Supplementary Figure 1 shows owchart of
survey invitees and response during each study cycle.
638 Ditah et al Clinical Gastroenterology and Hepatology Vol. 12, No. 4

Table 1. Denitions and/or Categorization of Operational Terms

Variable Denition/categories

Age Only individuals older than 20 years were eligible. Age was categorized as 2029 years, 3039 years, 4054 years,
5569 years, and 70 years and older.
Race On the basis of self-reported information, participants were classied into Mexican American and other Hispanic,
non-Hispanic white, non-Hispanic black, and other race/ethnicity groups.
Marital status It was classied as widowed, separated, or divorced; married or cohabitating with a partner; and never married.
Education level Education was dened as having less than a high school education, a high school diploma (including general
educational development [GED]), or additional education beyond high school.
Poverty Income was represented by the poverty income ratio (PIR), which varies by family size and composition (www.census.
index ratio gov/hhes/www/poverty/denitions.html#ratio). For this study, participants were classied as at or above the
poverty threshold vs below the threshold.
Body mass index The body mass index (BMI) was calculated as measured weight (kg)/height (m2); overweight was dened by a BMI
of 25.029.9 kg/m2, and obesity was dened by a BMI >30 kg/m2.
Physical activity Vigorous physical activity was dened as activity done for at least 10 minutes in the past 30 days that caused heavy
sweating or large increases in breathing or heart rate; moderate physical activity was dened as activity done for
at least 10 minutes that caused only light sweating or a slight to moderate increase in breathing or heart rate.
Pregnancy Pregnancy status was assessed by participant self-report and/or a urine pregnancy test.
Diabetes mellitus Diabetes mellitus was dened as a positive response to any of 3 questions: (1) Have you ever been told by a doctor
or other health professional that you have diabetes or sugar diabetes?, (2) Are you now taking insulin?,
and (3) Are you now taking diabetic pills to lower your blood sugar?
Chronic illnesses The presence of Chronic illnesses was ascertained by 13 separate questions on the form: Have you ever been told
by a doctor that you have arthritis, congestive heart failure, coronary heart disease, angina or angina pectoris,
heart attack, stroke, emphysema, chronic bronchitis, chronic liver condition, cancer or malignancy, asthma,
anemia, visual problems, or osteoarthritis? The cumulative number of positive responses to these 13 questions
was divided into 3 categories: 0 (none), 12, and 3 or more.
General health Self-described general health status was dened by the question Would you say that in general your health is
status excellent, very good, good, fair, or poor? Responses to this question were aggregated into 2 ranges: excellent,
very good, or good health status versus fair or poor health.
Urinary Urinary incontinence was assessed by using the Incontinence Severity Index,37,38 which consists of 2 questions:
incontinence How often do you have urinary leakage? Would you say never, less than once a month, a few times a month,
a few times a week, or every day and/or night (responses coded 15)? and How much urine do you lose each
time? Would you say drops, small splashes, or more (responses coded 13)? This questionnaire is scored by
multiplying responses to the 2 questions, and scores of 3 or greater are classied as at least moderately severe
urinary incontinence.37,38 In this study, urinary incontinence was dened as a score of at least 3.

Demographic Characteristics of Survey 1.13% of population. FI consisted of liquid stool in the

Participants
The study population was made up of 7511 women
(51.3%) and 7248 men (48.7%). The mean (and median)
age of the study participants was 49 years (standard
deviation, 18). All age groups were well-represented and
mirrored the overall U.S. population. Hispanic subjects
represented 13.4%, and non-Hispanic black subjects
were 10.18% of study population. Supplementary
Table 1 shows the demographic characteristics of all
participants.
majority of cases. Table 2 shows prevalence of FI by
composition and frequency of leakage per week. Incon-
tinence by more than one consistency was reported by
28% (95% CI, 26.529.3) of participants with FI.
Figure 1 shows the prevalence of FI by age group and
gender. There was a linear upward trend in the overall
Table 2. Prevalence of FI by Stool Type and Frequency of
Leakage
Male Female Overall

Composition of leakage
Prevalence of Fecal Incontinence Solid 1.4 2.2 1.8
Mucus 2.77 3.2 3.0
Liquid 5.44 6.9 6.2
The overall prevalence of FI among civilian non-
Frequency of leakage (no. of bowel
institutionalized U.S. adults 20 years and older was movements per wk)
8.39% (95% CI, 7.769.05). This represents a total of <3 6.65 8.43 7.53
about 19 million non-institutionalized individuals in the 321 9.62 9.86 9.79
United States who report at least 1 episode of FI during 22 13.21 24.83 18.1
the last 30 days as of 2010. The prevalence of FI was
higher in women (9.4%; 95% CI, 8.810.27) than in men NOTE. Groups of subjects with different composition of leakage are not
(7.3%; 95% CI, 6.48.2). FI occurs at least weekly in mutually exclusive. All values are expressed as percents.
April 2014
Figure 1. Overall preva-
lence of FI by age (years)
and sex. (A) Trends in
FI prevalence by sex;
(B) Trends in overall
prevalence.
prevalence of FI by age group (P trend < .001) and sex.
FI increased from 2.91% (95% CI, 2.223.81) in the 20-
to 29-year-old subjects through 8.54% (95% CI,
7.389.87) in the 50- to 60-year-old subjects to 16.16%
(95% CI, 14.1518.39) in those 70 years and older.
Trends in Prevalence of Fecal Incontinence
The prevalence of FI did not change during the study
period. The overall prevalence was 8.3 (95% CI, 7.29.5)
in 20052006, 8.5% (95% CI, 7.59.6) in 20072008,
and 8.4% (95% CI, 7.29.8) in the 20092010 survey. By
gender, although the prevalence of FI decreased among
men from 7.7% in 20052006 through 7.3% in
Figure 2. Trends in FI from 20052010 by age group (years).
Current Epidemiology of FI in the US 639
20072008 to 6.8% in 20092010, there was an upward
trend among women from 8.9% in 20052006 through
9.6% in 20072008 to 10.0% in 20092010. Figure 2
shows the trends in FI prevalence from 20052010 by
age group. The greatest increase in FI prevalence was
observed in the 70 years and older group between the
years 20072008 and 20092010. Figure 3 shows the
trend in prevalence by gender and survey cycle. The
prevalence of the different types of FI did not vary
signicantly during the 5 years.
Risk Factors Associated With Fecal
Incontinence
Table 3 shows the bivariate and multivariate analysis
for factors associated with FI. The signicant limit for a
factor to be included in the multivariate model was set at
0.1. From the multivariate analysis, risk factors for FI
included age (>55 years), diabetes mellitus, male gender,
UI, frequent and loose stools, poor health status, and 3
chronic illnesses. Obesity, parity, and number of preg-
nancies were not associated with FI. To further explore
the reason for the switch from female to male gender (in
the multivariate) as risk factor, the model was built
Figure 3. Trends in FI prevalence by sex and survey cycle
from 20052010.
640 Ditah et al Clinical Gastroenterology and Hepatology Vol. 12, No. 4

Table 3. Bivariate and Multivariate Analysis for Factors Associated With FI

Bivariate analysis Multivariate analysis

Risk factor OR (95% CI) P value OR (95%) P value

Age group ( y)
2029 Baseline
3039 1.70 (1.212.40) .003 0.92 (0.501.71) >.05
4054 3.12 (2.244.34) <.001 1.48 (0.832.63) >.05
5569 4.56 (3.495.95) <.001 1.89 (1.073.37) .01
70 6.44 (4.738.76) <.001 2.05 (1.193.73) .003
Body mass index (kg/m2)
<25 Baseline
2529.9 0.95 (0.791.14) .56 0.91 (0.651.27) >.05
>30 1.30 (1.081.56) .006 1.01 (0.731.40) >.05
Self-reported health status
Good Baseline
Poor 1.21 (1.792.55) .06 1.32 (1.021.71) .04
Sex
Male Baseline
Female 1.28 (1.111.47) .001 0.67 (0.510.89) .006
Ethnicity
Hispanic Baseline
Non-Hispanic white 1.15 (0.981.35) .08 1.37 (0.981.94) >.05
Non-Hispanic black 1.12 (0.891.41) .31 1.00 (0.651.56) >.05
Marital status
Single Baseline
Divorced/separated 1.04 (0.781.40) .77 0.86 (0.481.34) >.05
Married 0.84 (0.671.06) .14 0.65 (0.440.98) >.05
Poverty index ratio
Above Baseline
Below 1.21 (1.011.47) .06 1.05 (0.791.39) >.05
Education
11th grade Baseline
High school 0.82 (0.680.97) .023 0.79 (0.551.13) >.05
<High school 1.01 (0.851.18) .95 0.95 (0.671.34) >.05
UI
No Baseline
Yes 1.65 (1.272.14) <.001 1.63 (1.222.17) .001
Diabetes mellitus
No Baseline
Yes 1.20 (1.061.35) .005 1.52 (1.112.07) .01
Physical activity
No Baseline
Yes 0.91 (0.821.01) .08 1.11 (0.821.51) >.05
Frequency of bowel movements (per wk)
<3 Baseline
320 0.67 (0.500.90) .009 0.97 (0.601.57) >.05
21 1.85 (1.322.59) .001 2.46 (1.414.29) .001
Stool consistency
Usual Baseline
Hard, lumpy 1.11 (0.821.50) .07 0.87 (0.521.46) >.05
Loose, watery 3.52 (2.844.36) <.001 2.52 (1.793.56) <.001
Vaginal deliveries (women only)
0 Baseline
13 1.03 (0.781.37) .83 n/a n/a
4 1.13 (0.831.54) .44 n/a n/a
Pregnancies
0 Baseline
13 1.15 (0.62.240) .67 n/a n/a
4 1.40 (0.434.60) .67 n/a n/a
Chronic illnesses
Baseline (none)
1 or 2 1.41 (1.151.72) .001 0.98 (0.701.36) >.05
3 2.47 (2.03.05) <.001 1.74 (1.252.42) .008

NOTE. Only variables found to be signicant in age-adjusted bivariate analyses with alpha threshold of 0.1 were included in the multivariate regression and shown
in this table. Multivariate odds ratios are adjusted for all other risk factors in the table.
n/a, not included in the multivariable logistic model.
April 2014
forward by adding one variable at a time. We noted that
this switch occurred when UI was introduced into the
model. In addition, interactions between UI, age, and
gender did not yield statistically signicant effect modi-
cation. However, effect modication between age and
gender was noted, with women being more likely to have
FI with increasing age (odds ratio, 1.02; P .03).
Discussion
FI remains a common problem affecting 8.39%, ie,
approximately 19 million, of U.S. adults 20 years and older.
Economically, this translates into annual direct costs of
about 78 billion dollars.6,7 Estimates on the prevalence of
FI have varied widely. These inconsistencies have been
mostly attributed to differences in sample populations
and denitions of FI. Estimates from referral or specic
subgroups of the populations overestimate the true
magnitude of FI. NHANES is a national population-based
survey of U.S. residents. The rst national prevalence of
FI among U.S. adults was reported in 2009.3 However,
this study used data only from the NHANES 20052006
cycle, thus it is limited in numbers. Our study used data
during 3 survey cycles and represents the largest sample
on FI at the population level in the United States.
Estimates from this data set conrm previous ndings
from smaller studies conducted in the community
around the United States.8,17,22,23 Studies conducted in
similar settings in Korea, Spain, and New Zealand found
that the prevalence of FI was signicantly lower than
those reported from studies that targeted specic
populations.2426 The study from New Zealand found a
slightly higher prevalence of FI (12.4%).26 However, this
study included both institutionalized and non-
institutionalized individuals, whereas NHANES includes
only non-institutionalized individuals. FI is one of the
primary reasons for admittance to nursing homes, and
higher rates have previously been reported.9,15,16,2629
We believe that the true prevalence of FI lies somewhere
between the numbers reported in community-based
studies and those in long-term care centers.
This study documents trends in the prevalence of FI
in the United States. We hypothesized that with the
projected demographic changes in age in the United
States, the prevalence of FI was on the rise. Our study
showed that the prevalence of FI was relatively stable
between 2005 and 2010. However, the prevalence
increased steadily among the 70 years and older age
group during the study period, as shown in Figure 2. The
largest increase (3.0%, P < .001) in this age group
occurred between 20072008 and 20092010.
Most discussions on the etiology of FI have been based
on the assumption that women are more at risk than men.
Yet, several population-based studies have reported
no gender differences3,23,28 or, surprisingly, a high
prevalence in men.14,3033 In this study, we noted a male
predominance in the younger age groups, with a gradual
Current Epidemiology of FI in the US 641
transition to female predominance in the older age
groups. From 2005 to 2010, the prevalence decreased
among men, whereas there was a steady increase among
women. The reasons for these contrasting trends are
unclear. It has been speculated that obstetric injuries
probably contribute to the higher prevalence of FI
among women.34,35 However, a number of studies have
failed to nd a consistent association between FI and
vaginal delivery.3,8,12,13,23,3638 This study showed that
number of vaginal deliveries or parity was not
associated with FI. Unfortunately, our data set did not
have information to specically assess the role of
operative deliveries or obstetric injury.
One of our objectives was to identify risk factors for FI.
Increasing age has been consistently shown to be associ-
ated with FI.3,28,33,36,38,39 Some authors have argued that
this association is probably confounded by limited
mobility, multiple comorbidities, or overall poor health
status. We were able to adjust for most of these factors,
and yet age remained associated with FI. FI preventive
strategies should focus on proper management of
diabetes mellitus and control of diarrhea. There have
been studies showing that when FI exists in the context of
diarrhea, treating the latter often leads to improvement of
the former.40,41 Having multiple comorbidities, considered
a surrogate for limited mobility, has been associated with
FI.3,22,23 We noted a similar association in this study.
Multiple illnesses probably impact physical ability to
carry out ones activities of daily living, including making
it to the restroom.
Consistent with prior reports, we found a strong asso-
ciation between FI and UI.22,38 We believe that the strong
association between FI and UI likely reects a common
etiologic pathway (common innervations)34,35,42 rather
than either being a risk factor for the other. We found an
interesting relationship between FI, UI, and gender. In the
age-adjusted bivariate analysis, female gender was
strongly associated with FI. Surprisingly, in the
multivariate analysis, men appeared to be at higher risk
of FI. This switch was entirely explained by the presence
of UI. This nding was not explained by effect
modication between UI and gender or age. However,
effect modication was noted, with women being more
likely to have FI with increasing age. This result suggests
that all risk factor analysis studies on FI should take into
consideration the presence or absence of UI.
Recent reports have found a higher prevalence of FI
among obese individuals.25,4346 Obesity might
contribute to FI by increasing the intra-abdominal
pressures. In this study, obesity (body mass index >30
kg/m2) was not associated with FI in a multivariate
model. The association between obesity and FI is
controversial. Whereas some authors have noted an
improvement in FI with weight loss,47 others have
noted an increase.24 The association is even more
complex in the context of bariatric surgery where an
increased prevalence of FI has been described,
especially when diarrhea is present.43
642 Ditah et al
This study has several strengths. The majority of pre-
vious studies on FI have come from single institutions and
were plagued by referral bias. Our sample is nationally
representative, with all segments of the population
including minorities well-represented. The standardization
of the NHANES survey procedure and denitions of FI en-
sures high quality data collection. The NHANES survey
design also partially bypasses the drawback of previous
studies, which is the underreporting of FI owing to patients
reluctance to voluntarily report this to care providers.14,33
Another strength of our study is the large number
of subjects. The latter provides statistical power to study
factors associated with FI. A few limitations of this
study are worth mentioning. This analysis included only
non-institutionalized individuals. These estimates are
therefore an underestimation of the true magnitude of the
problem because a signicant proportion of individuals
with FI live in nursing homes.2,4,79 NHANES is a cross-
sectional design, and thus incidence and causality cannot
be established.
Conclusions
We have presented robust estimates of the preva-
lence, trends, and risk factors of FI in a nationally
representative database of non-institutionalized adults in
the United States. We found that FI is a common disorder
in the United States, affecting about 19 million in-
dividuals as of April 2010. The prevalence of FI remained
relatively stable between 2005 and 2010. Loss of liquid
stool is the most common type of FI. Preventive strate-
gies should focus on diabetes control and management of
diarrhea. Future studies on the risk factors for FI should
consider presence or absence of UI.
Supplementary Material
Note: To access the supplementary material accom-
panying this article, visit the online version of Clinical
Gastroenterology and Hepatology at www.cghjournal.org,
and at http://dx.doi.org/10.1016/j.cgh.2013.07.020.
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Current Epidemiology of FI in the US 643
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Reprint requests
Address requests for reprints to: Ivo Ditah, MD, MPhil, Division of Gastroen-
terology and Hepatology, Mayo Clinic and Foundation, 200 First Street SW,
Rochester, Minnesota 55905. e-mail: Ditah.ivo@mayo.edu; fax: (507)
284-0538.
Conicts of interest
The authors disclose no conicts.
643.e1 Ditah et al Clinical Gastroenterology and Hepatology Vol. 12, No. 4

Supplementary Figure 1. Survey cycle invitees and response rate regarding FI questionnaire.
April 2014 Current Epidemiology of FI in the US 643.e2

Supplementary Table 1. Characteristics of Study Participants

Characteristics Male (%) Female (%) Total (%)

Sex
Age group (y) 7248 (48.74) 7511 (51.26) 14,759 (100)
2029 1193 (19.67) 2597 (17.99) 2597 (18.81)
3039 1210 (18.65) 1241 (17.57) 2451 (18.1)
4054 1877 (31.66) 1936 (31.22) 3813 (31.44)
5569 1663 (19.9) 1662 (20.61) 3325 (20.27)
70 1305 (10.12) 1268 (12.61) 2573 (11.4)
Race (ethnicity)
Hispanic 1890 (13.37) 2076 (11.74) 3966 (12.53)
Non-Hispanic white 3631 (71.02) 3637 (71.05) 3966 (71.03)
Non-Hispanic black 1437 (10.18) 1492 (11.73) 2929 (10.97)
Other 290 (5.44) 306 (5.48) 596 (5.46)
Education level
<High school 2942 (37.19) 2984 (36.03) 5926 (36.59)
High school 965 (6.82) 819 (5.30) 1784 (6.04)
>High school 3336 (55.9) 3697 (58.59) 7033 (57.3)
Marital status
Married 4844 (68.77) 4188 (61.58) 9032 (65.09)
Divorced/separated/widow 1187 (13.26) 2135 (23.19) 3322 (18.35)
Never married 1213 (17.93) 1184 (15.15) 2397 (1.5)
Poverty index ratio
Below 1303 (28.21) 1167 (25.14) 2470 (26.64)
Above 5424 (71.79) 5784 (74.86) 11,208 (73.36)
Self-reported health status
Good 5589 (83.7) 5683 (82.83) 11,272 (83.25)
Poor 1658 (16.29) 1827 (17.16) 3485 (16.75)
UI
Yes 381 (39.2) 852 (32.910) 1233 (34.36)
No 701 (60.8) 2142 (67.09) 2848 (65.64)
Body mass index (kg/m2)
<25 1918 (26.65) 2279 (35.81) 4197 (31.35)
2529.9 2824 (39.46) 2194 (28.16) 5018 (33.66)
>30 2431 (33.89) 2971 (36.04) 5402 (34.99)
Physical activity
No activity 3455 (42.12) 4389 (52.63) 7844 (47.51)
Moderate 1661 (24.7) 1958 (28.68) 3619 (26.74)
Vigorous 2132 (33.18) 1164 (18.69) 3296 (25.75)
Frequency of bowel movements (per wk)
<3 3591 (4.2) 844 (11.33) 1203 (7.86)
320 6312 (88.22) 6202 (83.43) 12,514 (85.76)
21 577 (7.58) 465 (5.2) 1042 (6.38)
Diabetes mellitus
Yes 854 (8.12) 861 (8.27) 1715 (8.2)
No 6240 (89.9) 6522 (90.09) 12,762 (90.01)
Chronic illnesses
None 3449 (52.1) 3144 (43.68) 6593 (47.78)
12 2936 (39.06) 3392 (44.67) 6328 (41.94)
3 or more 863 (8.84) 975 (11.65) 1838 (10.28)

NOTE. All results are reported as n (%). Respondents with missing data, refused, or responded with dont know were excluded from the table.