Bowel Habits EVALUATION and Anal Incontinence RISK Factors IN the GENERAL POPULATION

The objective of this study was to evaluate the bowel habits and anal incontinence risk factors in adults living in the urban area of Londrina, Brazil. This population-based, transversal epidemiological study was carried out after being approved by the University of São Paulo Nursing School Ethics Committee. Population sample established from a stratified sampling procedure by a conglomerate constituted of streets taken randomly from 390 county census sectors, included 2162 individuals, 18 years old and over, in adequate physical and mental conditions, who accepted to participate in the study. All residents in the selected streets who met the inclusion criteria established by the study were interviewed, using two instruments: Demographic data and the Bowel function in the community. Data were submitted to Chi-square and Fischer exact tests. There was a predominance of female subjects (1203/56%); ages  40,6 ± 16,4; white (1591/74%); with a stable relationship (1290/60%), with 9 to 12 years of formal education ( 784/36%), subjects  without a defined job (37%) with salaries around  2 to 3,9 / minimum wage (44%)  and per capita income between 0,6 to one/minimum wage (38%). As for normal intestinal pattern (1.875/87%; p<0,0001), there was the predominance of one bowel movement per day (1.133/52%; p<0,0001), among women (968/52%; p<0,0001); whites (1591/85%; p<0,0001), absence of defecation strain  (1956/90%), soft feces (1379/64%), total rectal emptying  (1938/90%). Constipated intestinal pattern (261/12,1%), among women (219/84%), defecation strain (99/41,8%), hard feces (176/67%); incomplete rectal emptying (99/38%). Diarrheic intestinal pattern (26/1,2%), no defecation strain (26/100%) liquid and soft feces (5/19%), total rectal emptying  (16/61%). Prevalence of anorectal diseases was 53 (2%) abscesses, 22 (1%) fistules, 81 (3%) fissures, 20(1%) rectal prolapse, 30 (1%) anal traumas; 229 (11%) hemorrhoidal disease 58 (3%) ; anorectal surgeries, mainly among females. Gynecological and delivery history, 886 (74%) had deliveries, 709 (73%) with normal intestinal pattern; 432 (49%) between 31 and 50 years old; 168 (14%) had normal deliveries; 33 (3%) with postpartum laceration that needed surgical intervention; however, they maintained a normal intestinal pattern (25/75%); 109 (9%) had hysterectomy (109 /9%), 90 (90%) normal intestinal pattern  and less than one percent had rectocele and four (50%) were constipated. Anal incontinence risk factors, 35 (2%) pelvic radiotherapy,  133 (6%) diabetes mellitus, 330 (15%) nervous systems diseases and dysfunctions, 291 (13%) spinal cord lesion and 29 (1%) reported having had an encephalic vascular stroke. In all factors there was the predominance of the normal intestinal pattern; however, females presented more nervous system dysfunctions and encephalic vascular strokes. This study reports on the bowel habits of a general population in a city in Northern Paraná, and the AI risk factors they are exposed to, bringing more information about the topic to the population and to those who work in the area , helping develop prevention programs or early diagnoses of intestinal diseases.