P2352 - Coexistent FecaI Incontinence and Constipation: Examination of Clinical and Physiological Features

Raguraj Chandradevan, MBBS¹, Chakravarthy Nulu, MS¹, Manav Kumar, BS², Aneesha Gummadi, MS³, Anam Herekar, MD³, Dhanush Shimoga, MBBS¹, Tharshika Raguraj, MD³, Vikarsh Bhardwaj, MBBS⁴, Arsh Momin, MD⁵, Amanda Tyra, MS¹, Yun Yan, MD¹, Amol Sharma, MS, MD, FACG^1
1Medical College of Georgia at Augusta University, Augusta, GA; ²Nova Southeastern University, Davie, FL; ³Augusta University, Augusta, GA; ⁴Jawaharlal Nehru Medical College, New Dehli, Delhi, India; ⁵Penn State Health Milton S. Hershey Medical Center, Atlanta, GA

Introduction: Fecal incontinence (FI) and constipation are often considered separately. Coexistent FI and constipation is under-recognized & presents challenges. Our aim is better understanding the clinical & physiological characteristics of this cohort.

Methods: A retrospective review of adult patients undergoing anorectal function tests (ArFT) at MCG between 2018-2024 was conducted (IRB1828783). Patients were divided by 3 groups (FI, constipation, FI + constipation) complied with Rome IV criteria for FI and constipation and subdivided by gender. Descriptive statistics was used. In case of suspected large group differences, chi-square test and 2-sample t-test assuming unequal variance were used for qualitative and quantitative data, respectively.

Results: Eighteen percent of patients (136/739) had coexistent FI and constipation (M/F 115/21). Concordant ArFT findings for dyssynergic defecation (abnormal BET & Manometric dyssynergia) was slightly higher in women (F/M 54%/51%) with constipation, however coexistent FI and constipation had male predominance with (M/F 55%/52%). Fifty-six percent of women with coexistent FI and constipation reported pain with defecation and more than 80% reported excess straining during stooling, feeling of incomplete evacuation, abdominal pain and bloating. All of this symptom profile in women were reported more common than FI group and less common than constipation group (p< 0.001). Resting anal sphincter pressure, max squeeze pressure, sustained squeeze pressure and anal residual pressure strain of coexistent FI and constipation group in women were significantly higher than FI group and significantly lower than constipation group (p< 0.001). In males, abdominal pain and pain during stooling were reported significantly in coexistent FI and constipation group (p< 0.05) and resting anal sphincter pressure, max squeeze pressure and sustained squeeze pressure of the coexistent FI and constipation group were significantly higher than FI group and significantly lower than constipation group. Higher frequency of digital maneuvers was reported in women in coexistent FI and constipation group (p< 0.05). No significant difference noted in between rectal compliance and sensitivity among all three groups.

Discussion: Patients with coexisting FI and constipation has a unique clinical & anorectal physiology. It is also recognized that gender differences exist among this unique entity. Management of constipation or FI alone may not be sufficient to help these patients’ symptoms profile.


Disclosures:


Raguraj Chandradevan, MBBS¹, Chakravarthy Nulu, MS¹, Manav Kumar, BS², Aneesha Gummadi, MS³, Anam Herekar, MD³, Dhanush Shimoga, MBBS¹, Tharshika Raguraj, MD³, Vikarsh Bhardwaj, MBBS⁴, Arsh Momin, MD⁵, Amanda Tyra, MS¹, Yun Yan, MD¹, Amol Sharma, MS, MD, FACG¹. P2352 - Coexistent FecaI Incontinence and Constipation: Examination of Clinical and Physiological Features, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.