Affiliation:
1. Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford California USA
2. Clinical Observation and Medical Transcription Program Stanford University School of Medicine Stanford California USA
3. Atropos Health New York New York USA
4. Department of Surgery Stanford University Stanford California USA
Abstract
AbstractBackgroundVitamin‐D is essential for musculoskeletal health. We aimed to determine whether patients with fecal incontinence (FI): (1) are more likely to have vitamin‐D deficiency and, (2) have higher rates of comorbid medical conditions.MethodsWe examined 18‐ to 90‐year‐old subjects who had 25‐hydroxy vitamin‐D levels, and no vitamin‐D supplementation within 3 months of testing, in a large, single‐institutional electronic health records dataset, between 2017 and 2022. Cox proportional hazards survival analysis was used to assess association of vitamin‐D deficiency on FI.Key ResultsOf 100,111 unique individuals tested for serum 25‐hydroxy vitamin‐D, 1205 (1.2%) had an established diagnosis of FI. Most patients with FI were female (75.9% vs. 68.7%, p = 0.0255), Caucasian (66.3% vs. 52%, p = 0.0001), and older (64.2 vs. 53.8, p < 0.0001). Smoking (6.56% vs. 2.64%, p = 0.0001) and GI comorbidities, including constipation (44.9% vs. 9.17%, p = 0.0001), irritable bowel syndrome (20.91% vs. 3.72%, p = 0.0001), and diarrhea (28.55% vs. 5.2%, p = 0.0001) were more common among FI patients. Charlson Comorbidity Index score was significantly higher in patients with FI (5.5 vs. 2.7, p < 0.0001). Significantly higher proportions of patients with FI had vitamin‐D deficiency (7.14% vs. 4.45%, p < 0.0001). Moreover, after propensity‐score matching, rate of new FI diagnosis was higher in patients with vitamin‐D deficiency; HR 1.9 (95% CI [1.14–3.15]), p = 0.0131.Conclusion & InferencesPatients with FI had higher rates of vitamin‐D deficiency along with increased overall morbidity. Future research is needed to determine whether increased rate of FI in patients with vitamin‐D deficiency is related to frailty associated with increased medical morbidities.