Asthma and Chronic Obstructive Pulmonary Disease Are Associated with an Increased Risk of Developing Fecal Incontinence

Background: Fecal incontinence (FI) is a common condition associated with aging. Asthma and chronic obstructive pulmonary disease (COPD) are obstructive lung diseases associated with both urinary incontinence and increased intraabdominal pressures. Objective: We sought to evaluate whether these obstructive lung diseases increase the risk of developing FI. Methods: We prospectively examined the association between asthma, COPD and asthma/COPD overlap and risk of FI among women from the Nurses’ Health Study (NHS). We defined incident FI as ≥ 1 liquid or solid FI episode/month during four years of follow-up using self-administered, biennial questionnaires (2008–2012). Validated self-report of asthma and COPD were used from 1988 to 2008. We used Cox proportional hazards models to calculate multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for FI risk associated with obstructive lung diseases. Results: We documented 6,091 cases of incident FI in the asthma cohort (n = 54,444, with asthma 6,100, without asthma 48,344). Compared to women without asthma, the aHR for FI in those with asthma was 1.18 (95%CI 1.09–1.27). We documented 5,834 cases of incident FI in the COPD cohort (n = 51,837, with COPD 3,484, without COPD 48,353). Compared to women without COPD, the aHR for FI in those with COPD was 1.16 (95%CI 1.05–1.27). We documented 5,773 cases of incident FI in the asthma/COPD cohort (n = 51,156, with asthma/COPD overlap 2,803, without 48,353). Compared to women without asthma/COPD overlap, the aHR for FI in those with asthma/COPD overlap was 1.28 (95%CI 1.16–1.42). Conclusion: Asthma and COPD are associated with increased risk of developing FI. Further studies are needed to elucidate the pathophysiology driving this association.