BACKGROUND & AIMS The diagnostic criteria for fecal incontinence (FI) were made more restrictive in the Rome IV revision. We aimed to determine the characteristics of FI patients defined by the Rome IV criteria, assess how FI frequency and amount affect quality of life, identify risk factors, and compare prevalence values among countries. METHODS We performed an internet-based survey of 5931 subjects in the United States, Canada, and the United Kingdom, from September to December 2015. Subjects were stratified by country, sex, and age. Responders answered questions about diagnosis, health care use, and risk factors. We performed multivariate linear regression analysis to identify risk factors for FI. RESULTS FI was reported by 957 subjects (16.1%) but only 196 (3.3%) fulfilled the Rome IV criteria. Frequency of FI was less than twice a month for 672/957 subjects (70.2%) and duration was less than 6 months for 285/957 subjects (29.8%). Quality of life was significantly impaired in all subjects with FI compared to subjects with fecal continence. The strongest risk factors for FI were diarrhea, urgency to defecate, and abdominal pain. FI was more prevalent in the United States than in the United Kingdom. Between-country differences were due to less diarrhea and urgency in the United Kingdom. CONCLUSIONS Rome IV FI prevalence is lower than previous estimates because the new criteria exclude many individuals with less frequent or short duration FI. These excluded patients have impaired quality of life. It might be appropriate to make a diagnosis of FI for all patients with FI ≥2 times in 3 months and to provide additional information on frequency, duration, and amount of stool lost to assist clinicians in treatment selection.

中文翻译：

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美国、加拿大和英国的罗马 IV 标准诊断的大便失禁。

背景和目的 大便失禁 (FI) 的诊断标准在罗马 IV 修订版中变得更加严格。我们旨在确定罗马 IV 标准定义的 FI 患者的特征，评估 FI 频率和数量如何影响生活质量，识别风险因素，并比较各国之间的患病率值。方法 我们在 2015 年 9 月至 12 月期间对美国、加拿大和英国的 5931 名受试者进行了一项基于互联网的调查。受试者按国家、性别和年龄进行分层。响应者回答了有关诊断、医疗保健使用和风险因素的问题。我们进行了多元线性回归分析以确定 FI 的危险因素。结果 957 名受试者 (16.1%) 报告了 FI，但只有 196 名 (3.3%) 符合罗马 IV 标准。672/957 名受试者 (70.2%) 的 FI 频率少于每月两次，285/957 名受试者 (29.8%) 的持续时间少于 6 个月。与大便失禁的受试者相比，所有 FI 受试者的生活质量均显着受损。FI 的最强风险因素是腹泻、排便急迫和腹痛。FI 在美国比在英国更普遍。国家之间的差异是由于英国的腹泻和紧急情况较少。结论 罗马 IV FI 患病率低于之前的估计值，因为新标准排除了许多频率较低或持续时间较短的 FI 个体。这些被排除在外的患者的生活质量受损。