FECAL INCONTINENCE
Fecal incontinence
Fecal incontinence refers to an unintentional leak or discharge of stools or gas.
In this case, the patient may find unable to control the bowel movements which may cause an unexpected leak of feces from the rectum. It is also called bowel incontinence which ranges from passing gas to losing bowel control. This happens when one or more of the internal body parts or components stop working properly which results in losing control over the evacuation of feces.
Types of Fecal Incontinence
Fecal Incontinence is experienced by the adults when they are suffering from diarrhea. Generally, two kinds of fecal incontinence situations are found:- Urge Incontinence & passive Incontinence
- Urge Incontinence: If people have a urge and unable to control the discharge of the stools and they even don't make it in the toilet, it is called urge incontinence.
- Passive Incontinence: If people are not aware of the need to pass stool, this is called passive incontinence.
Symptoms of Fecal Incontinence
occasional bout of diarrhea.
Fecal incontinence may be accompanied by other bowel problems, such as:
- Diarrhea
- Constipation
- Gas and bloating
When to see a doctor: Visit the doctor immediately if you notice any of the symptoms.
Do not feel hesitated as definitive and proven treatments are available for Fecal Incontinence.
Causes of Fecal Incontinence
There can be one or more causes of fecal incontinence as per listed below:-
- Muscle Damage: This is referred as the injury to the rings of muscle at the end of the rectum or anal sphincter which may occur during childbirth. This happens when someone went through episiotomy or forceps surgery during delivery. In this case, holding the stools may be hard for the patients.
- Nerve Damage: It can happen due to continuous straining during bowel movements, childbirth, spinal cord injury or stroke. These things may damage the nerve causing fecal incontinence. Diseases such as Diabetes or Multiple sclerosis also affect the nerves.
- Constipation: Chronic constipation may lead to dry and hard stools which are hard to pass through the rectum. This may lead to stretch and weaken the rectum and intestines and may allow the watery stools to come out through the anal. It may also cause the nerve damage and may lead to fecal incontinence.
- Diarrhea: Loose or watery stools are had to carry in the rectum which may cause and worsen the fecal incontinence.
- Loss of storage capacity in rectum: To hold the stools, rectum gets stretched but due to some surgeries, radiation treatments or inflammatory bowel disease, the rectum may not able to stretch as much as it is required which may lead to having less storage to hold the waste components, resulting in fecal incontinence.
- Surgery:- Some surgeries to treat the veins of the rectum, anus may cause nerve and muscle damage which may lead to fecal incontinence.
- Rectal prolapse: If rectum drops down into the anus.
- Rectocele: If rectum protrudes through the vagina in women.
Whatever the cause of fecal incontinence, it is quite embarrassing to face such problems so better to consult the doctor at right time to have successful treatments and to improve quality of lifestyle.
Risk factors for fecal incontinence
Some of the risk factors involved in developing the fecal incontinence are as given below:-
- Being Female: It is more common in women as they have the capability of childbirth. It is more developed after the age of 40 when some pelvic injury occurs during childbirth although actual cause or symptoms are not clear.
- Age: This is common among the middle-aged and old-aged people due to weakness in nerve and muscle of anal.
- Nerve Damage: People suffering from long-term diabetes and multiple sclerosis may lead to the stage of uncontrollable defecation.
- Dementia: It is found in late-stage Alzheimer’s disease and dementia
- Physical Ability: Physically disables people may find trouble in reaching to the toilet in time. Some injury which leads to physical disability may also lead to nerve & muscle damage of rectum part. People may have constipation problem due to the inactive physical body which results in fecal incontinence.
Complications of Fecal Incontinence
- Emotional Distress People suffering from fecal incontinence may lead to stress, embarrassment, facing the public, shame, frustration, anger, and depression. They may try to avoid social engagements. They may be seen in emotional trauma.
- Skin Irritation: As we know, lower part skin (anus) is sensitive. regular discharge of stools may lead to irritation, itching, ulcers or wounds which requires medical treatments to avoid infection and serious problems thereof.
Diagnosis of Fecal Incontinence
The doctor will make sure to analyze the symptoms and causes by asking you few questions and analyzing the complete physical body check-ups. Some of the medical tests and diagnosis methods are given below:-
- Digital Rectal Exam:- In this process, the doctor will wear gloves and will insert the lubricated finger into the rectum to evaluate the strength of your sphincter muscle and to see any abnormalities. The doctor may ask the patient to bear down to check the rectal prolapse.
- Balloon Expulsion Test:- the Small balloon filled with water is inserted into rectum. The doctor will ask you to expel the balloon in the toilet. The duration will be recorded. If one minute or more than is taken, it is a sign of a defecation disorder.
- Anal Manometry:- In this process, narrow & flexible tube, containing balloon on the tip is inserted into anus or rectum. The small balloon may be expanded to check the tightness of your anal sphincter, the functionality of rectum a sensitivity of the skin.
- Anorectal Ultrasonography:- Wand like instrument is inserted into anus and rectum which captures video images and allow the doctor to evaluate the structure of sphincter
- Proctoscopy:- Patient may be sent to a specially designed toilet where a patient may be asked to perform bowel movements. Xray video images will be made to measure how much stool your rectum may hold or how well your body expels the stools.
- Proctosigmoidoscopy:- Flexible tube is inserted into rectum to inspect the last two feet of the colon to check the signs of inflammation, tumors, scar tissue which are responsible for fecal incontinence
- Colonoscopy:- It is done to measure the complete colon with the help of flexible tube inserted through the rectum.
- Magnetic Resonance Imaging (MRI):- It provides the clear pictures of the sphincter to check if muscles are intact. It also captures the images during defecation.