Table of Contents

Component Description

The Bowel Health section of the mobile exam center (MEC) interview (variable name prefix BHQ) provides personal interview data on fecal incontinence and defecating function for adults age 20 years and older.

Questions BHQ010 – BHQ040 comprise the Fecal Incontinence Severity Index (FISI) (Rockwood, 1999) which applies a type x frequency matrix to obtain the subject’s perception of symptom severity. The four symptoms composing the index are incontinence of gas, mucus, liquid stool, and solid stool. The FISI responses are weighted on a 1-20 point severity scale and a total FISI score can be calculated.

Question BHQ060 is the Bristol Stool Form Scale. The stool consistency scale has been used in a series of studies. These studies have shown that a subject’s rating of his/her own individual stools (Probert,1993) is robustly correlated with measures of how long it takes radiopaque markers to pass through the gastrointestinal tract.

This component was first administered in the NHANES in 2005.

Eligible Sample

The target sample for the questions in this section is adults age 20 years and older. Frequency counts were verified during the preparation of the file.

Interview Setting and Mode of Administration

The Bowel Health (BHQ_F) section was administered in the Mobile Examination Center (MEC) during the MEC Interview by trained interviewers using a Computer-Assisted Personal Interviewing (CAPI) system. Hand cards showing response categories were used for some questions. These questions were asked of survey participants only; proxy respondents were not permitted.

For details on the administration of the Bowel Health (BHQ_F) section, please refer to the NHANES 2009-2010 MEC Interviewer Exam Manual and the Bowel Health CAPI Questionnaire on the NHANES website.

Quality Assurance & Quality Control

For details on the quality control/quality assurance process for this component, please refer to the NHANES 2009-2010 Interviewer Procedure Manuals on the NHANES website.

Data Processing and Editing

Times per day responses to BHD050 (How often do you have bowel movements?) were converted to times per week so that all responses are in times per week units.

Analytic Notes

New in 2009-2010:

  • BHQ070: During the past 12 months, how often have you had an urgent need to empty your bowels that makes you rush to the toilet?
  • BHQ080: During the past 12 months, how often have you been constipated?
  • BHQ090: During the past 12 months, how often have you had diarrhea?
  • BHQ100: In the past 30 days, did you take any laxatives or stool softeners to help move your bowels?
  • BHQ110: How many times have you taken laxatives or stool softeners in the past 30 days?

Survey participants with ostomies and gastrointestinal conditions such as irritable bowel syndrome are not identified in the data file.

Pregnant women were asked about their usual bowel habits when not pregnant. Exam sample weights should be used for analyses.

Please refer to the NHANES Analytic Guidelines and the on-line NHANES Tutorial for further details on the use of sample weights and other analytic issues.

References

Codebook and Frequencies

SEQN - Respondent sequence number

Variable Name:
SEQN
SAS Label:
Respondent sequence number
English Text:
Respondent sequence number.
Target:
Both males and females 20 YEARS - 150 YEARS

BHQ005 - CHECK ITEM

Variable Name:
BHQ005
English Instructions:
BOX 1. CHECK ITEM BHQ005: IF INTERVIEW DONE ONLY WITH SURVEY PARTICIPANT (CODED '1' IN RIQ005), CONTINUE WITH BHQ010. OTHERWISE, GO TO THE END OF SECTION.
Target:
Both males and females 20 YEARS - 150 YEARS

BHQ010 - Bowel leakage consisted of gas?

Variable Name:
BHQ010
SAS Label:
Bowel leakage consisted of gas?
English Text:
Next, we'd like to talk to you about bowel health. We'll start with accidental bowel leakage. There are four types of bowel leakage that can happen: leakage (passing) of gas, leakage of mucus, leakage of liquid stool, and leakage of solid stool. We will ask you about leakage of each of these one at a time. How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of gas? Would you say . . .
English Instructions:
HAND CARD BHQ1 CAPI INSTRUCTION: HELP SCREEN SHOULD READ: The bowel is another name for the intestines. Other names for the bowel include guts or innards. Accidental bowel leakage is leaking from the bowel or intestines that can't be controlled. Leakage of gas is also called passing gas, passing wind, or farting.
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 2 or more times a day 521 521
2 Once a day 446 967
3 2 or more times a week 402 1369
4 Once a week 278 1647
5 1-3 times a month 613 2260
6 Never 3002 5262
77 Refused 1 5263
99 Don't know 15 5278
. Missing 781 6059

BHQ020 - Bowel leakage consisted of mucus?

Variable Name:
BHQ020
SAS Label:
Bowel leakage consisted of mucus?
English Text:
How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of mucus?
English Instructions:
HAND CARD BHQ1 CAPI INSTRUCTION: HELP SCREEN SHOULD READ: Mucus is a thick, jelly-like substance made by the intestines that helps coat and protect the lining of the intestine. Mucus also helps stool pass through the large intestine and rectum more easily.
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 2 or more times a day 6 6
2 Once a day 18 24
3 2 or more times a week 17 41
4 Once a week 23 64
5 1-3 times a month 113 177
6 Never 5081 5258
77 Refused 0 5258
99 Don't know 19 5277
. Missing 782 6059

BHQ030 - Bowel leakage consisted of liquid?

Variable Name:
BHQ030
SAS Label:
Bowel leakage consisted of liquid?
English Text:
How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of liquid stool?
English Instructions:
HAND CARD BHQ1 CAPI INSTRUCTION: HELP SCREEN SHOULD READ: Stool is also called a bowel movement, BM, or poop.
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 2 or more times a day 14 14
2 Once a day 10 24
3 2 or more times a week 32 56
4 Once a week 26 82
5 1-3 times a month 272 354
6 Never 4907 5261
77 Refused 0 5261
99 Don't know 16 5277
. Missing 782 6059

BHQ040 - Bowel leakage consisted of solid stool?

Variable Name:
BHQ040
SAS Label:
Bowel leakage consisted of solid stool?
English Text:
How often during the past 30 days have you had any amount of accidental bowel leakage that consisted of solid stool?
English Instructions:
HAND CARD BHQ1
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 2 or more times a day 7 7
2 Once a day 6 13
3 2 or more times a week 16 29
4 Once a week 16 45
5 1-3 times a month 91 136
6 Never 5126 5262
77 Refused 0 5262
99 Don't know 15 5277
. Missing 782 6059

BHD050 - How often have bowel movements?

Variable Name:
BHD050
SAS Label:
How often have bowel movements?
English Text:
How often do you usually have bowel movements?
English Instructions:
PROBE: How many times per week do you usually have a bowel movement?
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 to 63 Range of Values 5262 5262
777 Refused 0 5262
999 Don't know 15 5277
. Missing 782 6059

BHQ060 - Common Stool Type

Variable Name:
BHQ060
SAS Label:
Common Stool Type
English Text:
Please look at this card and tell me the number that corresponds to your usual or most common stool type.
English Instructions:
HAND CARD BHQ2
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Type 1 (separate hard lumps, like nuts) 106 106
2 Type 2 (sausage-like, but lumpy) 286 392
3 Type 3 (like a sausage but with cracks in the surface) 1254 1646
4 Type 4 (like a sausage or snake, smooth and soft) 2694 4340
5 Type 5 (soft blobs with clear-cut edges) 464 4804
6 Type 6 (fluffy pieces with ragged edges, a mushy stool) 389 5193
7 Type 7 (watery, no solid pieces) 53 5246
77 Refused 0 5246
99 Don't know 31 5277
. Missing 782 6059

BHQ070 - Had an urgent need to empty bowels?

Variable Name:
BHQ070
SAS Label:
Had an urgent need to empty bowels?
English Text:
During the past 12 months, how often have you had an urgent need to empty your bowels that makes you rush to the toilet? Would you say ...
English Instructions:
HAND CARD BHQ3
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Always 57 57
2 Most of the time 159 216
3 Sometimes 1453 1669
4 Rarely 2157 3826
5 Never 1440 5266
7 Refused 1 5267
9 Don't know 10 5277
. Missing 782 6059

BHQ080 - In past 12 months been constipated?

Variable Name:
BHQ080
SAS Label:
In past 12 months been constipated?
English Text:
During the past 12 months, how often have you been constipated?
English Instructions:
HAND CARD BHQ3
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Always 108 108
2 Most of the time 203 311
3 Sometimes 993 1304
4 Rarely 1458 2762
5 Never 2507 5269
7 Refused 1 5270
9 Don't know 7 5277
. Missing 782 6059

BHQ090 - In past 12 months had diarrhea?

Variable Name:
BHQ090
SAS Label:
In past 12 months had diarrhea?
English Text:
During the past 12 months, how often have you had diarrhea?
English Instructions:
HAND CARD BHQ3
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Always 21 21
2 Most of the time 73 94
3 Sometimes 1119 1213
4 Rarely 2086 3299
5 Never 1968 5267
7 Refused 1 5268
9 Don't know 9 5277
. Missing 782 6059

BHQ100 - In past 30 days taken laxative?

Variable Name:
BHQ100
SAS Label:
In past 30 days taken laxative?
English Text:
In the past 30 days, did you take any laxatives or stool softeners, such as Ex-Lax, Metamucil or Fiberall, to help move your bowels?
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 592 592
2 No 4679 5271
7 Refused 0 5271
9 Don't know 6 5277
. Missing 782 6059

BHQ110 - Times taken laxative in past 30 days

Variable Name:
BHQ110
SAS Label:
Times taken laxative in past 30 days
English Text:
How many times have you taken laxatives or stool softeners in the past 30 days? Would you say...
Target:
Both males and females 20 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Most days 220 220
2 1-3 times a week 117 337
3 2-3 times a month 116 453
4 Once a month 136 589
7 Refused 2 591
9 Don't know 1 592
. Missing 5467 6059