Health-seeking behaviour among patients with faecal incontinence in a Malaysian academic setting

ABSTRACT

Background: Faecal incontinence (FI) is not a commonpresenting complaint in Malaysia, and little has beenpublished on this topic. Since it is a treatable condition, agreater understanding of factors contributing to healthseekingbehaviour is needed in order to plan effectiveprovision of services.Methods: A survey of 1000 patients and accompanyingrelatives, visiting general surgical and obstetrics andgynaecology clinics for matters unrelated to FI, wasconducted at University Malaya Medical Centre betweenJanuary 2009 and February 2010. A follow-up regressionanalysis of the 83 patients who had FI, to identify factorsassociated with health-seeking behaviour, was performed.Variables identified through univariate analysis weresubjected to multivariate analysis to determineindependence. Reasons for not seeking treatment were alsoanalysed.Results: Only eight patients (9.6%) had sought medicaltreatment. On univariate analysis, the likelihood of seekingtreatment was significantly higher among patients who hadmore severe symptoms (OR 30.0, p=0.002), had incontinenceto liquid stool (OR 3.83, p=0.002) or when there was analteration to lifestyle (OR 17.34; p<0.001). Nevertheless, theonly independently-associated variable was alteration inlifestyle. Common reasons given for not seeking treatmentwas that the condition did not affect patients’ daily activities(88.0%), “social taboo” (5.3%) and “other” reasons (6.7%).Conclusions: Lifestyle alteration is the main driver of healthseekingbehaviour in FI. However, the majority do not seektreatment. Greater public and physician-awareness on FIand available treatment options is needed.