Bladder and bowel symptoms experienced by people with chronic pain

Mrs Cheryl Ludwik1, Prof Terence Mills1, Dr  Helena Frawley2,3

1Bendigo Health, Bendigo, Australia, 2La Trobe University, Melbourne, Australia, 3Centre for Allied Health Research and Education, Cabrini Healthne , Malvern, Australia

Aim: Links have been identified between various pain conditions and bladder and bowel complaints. Symptoms can be distressing and the majority of sufferers do not seek help. The aim of this study was to estimate prevalence of incontinence (urinary or faecal) and constipation among both women and men with chronic pain, and compare these estimates with corresponding Australian community estimates.

Method: This was a questionnaire-based, prospective, cross-sectional cohort study of outpatients with chronic pain. Data collection included pain information and symptom scores for urinary incontinence, faecal incontinence and constipation. Prevalence rates for incontinence and constipation were compared to general community rates. Fisher’s exact test determined associations between variables.

Results: 82 participants responded. Urinary incontinence was reported by 65.8% [CI=55.6-76.1] of participants compared with 24% [CI=23-26] of the general Australian population. Faecal incontinence rate was 48.8% [CI=38.0-59.6], compared with 8% [CI=7-9] of the population data. Constipation was reported by 40.4% [CI=27.6-53.1] of women in the study which was not statistically different from prevalence data for age specific cohorts of Australian women. Low back pain (reported by 80.5% of participants) was associated with urinary incontinence (p=0.006) and faecal incontinence (p=0.004).

Significance of the findings to allied health: Community outpatients with chronic pain reported significantly higher prevalence of urinary and faecal incontinence than rates in the general Australian population.  Allied health clinicians who work with women and men experiencing chronic pain may consider routine screening for symptoms of incontinence, thereby improving opportunities to access appropriate services.