Fecal incontinence

Fecal incontinence, or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel content.

 

 

What is faecal incontinence?

Fecal incontinence is a lack of control over defecation which leads to involuntary loss of bowel including flatus, mucus or solid fecal matter.

Fecal incontinence is seen in?

Females are more likely to develop faecal incontinence than males.

Fecal incontinence affects people of all ages but is more common in older adults. Individuals of any race can be affected by faecal incontinence.

What are the risk factors for fetal incontinence?

Risk factors for fecal incontinence are as follows:-

-Age

-Female gender

-Urinary incontinence

-History of vaginal delivery

-Obesity

-Prior ano-rectal surgery

-Poor general health

Following are the causes of faecal incontinence:-

-Muscle damage:

Injury to the muscles of the rectum (anal sphincter) will make it difficult to hold stool back properly.

-Nerve damage:

Injury to nerves that control the anal sphincter can lead to faecal incontinence. The damage to the nerve can be caused by childbirth, constant straining during bowel movements, spinal cord injury or stroke. Some diseases like diabetes, and multiple sclerosis also affect these nerves and lead to fecal incontinence.

-Constipation: 

Constipation stool is dry and hard and difficult to pass or defecate.

-Radiation: 

Radiation also causes damage to the rectum in cases of prostate cancer.

-Cognitive impairment: 

Cognitive impairment after a stroke or in advanced Alzheimer’s disease.

-Inflammatory bowel disease: 

This disease can also lead to inflammatory injury to the rectum.

-Surgeries of the rectum in colorectal cancer: 

Surgery of rectum leads to scarring of the rectum due to which the walls of the rectum becomes stiff and inelastic.

Can nerve damage affect bowel movements?

Yes, nerve damage affects bowel movement and it can be caused by childbirth, any injury to the spinal cord, chronic constipation (constant straining during bowel movements) or stroke.

What are the investigations of faecal incontinence?

A physical examination helps a doctor to check the strength of the anal sphincter muscle.

Other tests to be done are as follows:-

-Stool testing

-Endoscopy

-Anorectal manometry

-Endosonography

-Nerve tests

-MRI defecography

How to treat faecal incontinence?

Bowel incontinence is usually treatable. In many cases, it can be cured completely. Treatment for fecal incontinence varies according to the cause:

-Diet.

These steps may be helpful:-

A more fibrous diet to be taken this makes stool bulkier and easier to control.

Avoid caffeine. This may help prevent diarrhoea.

Drink several glasses of water each day. This can prevent constipation.

-Medications.

Try these medicines to reduce the number of bowel movements and the urge to move the bowels:

Lomotil

Hyoscyamine

Methylcellulose can help make the liquid stool more solid and easier to control.

-Exercises.

Exercise(kegal excercise)

 

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