Description

Fecal incontinence is the accidental passing of solid or liquid stool. Fecal incontinence can happen when a person has a sudden urge to pass stools, and can't get to the bathroom in time. Also, the stool can be lost when a person does not feel the need to defecate.

Common causes of fecal incontinence include diarrhea, constipation, and muscle or nerve damage. Fecal incontinence can affect a person's ability to work, socialize, or do typical daily activities. It is often a cause of embarrassment or emotional stress.

The diagnosis and the treatment is often avoided because the condition is difficult to discuss with a health care professional. The treatments may improve fecal incontinence and quality of life in general.

Fecal incontinence can also be called bowel incontinence, accidental bowel leakage.

Symptoms

The main symptom is not being able to control bowel movements. This can happen during a short-term illness that causes diarrhea. For some people, fecal incontinence is a permanent condition.

There are two types of fecal incontinence:

  • Urge incontinence is the sudden need to defecate, but it will not be able to control the impulse. The need to evacuate the stool can come so suddenly that it is not possible to reach the bathroom in time.
  • Passive incontinence is to defecate when a person is not aware of the need to defecate. A person may not be able to feel that the rectum is full of stool.

Fecal incontinence can also be leakage of stool when a person passes gas.

When to see a doctor

Consult your health care professional if you or your child have fecal incontinence. This is especially important if the fecal incontinence:

  • It happens often.
  • Causes of emotional distress.
  • It affects your ability to perform daily activities.
  • It makes you to avoid the time with family and friends.

Often, people are embarrassed to talk about fecal incontinence. But before you are evaluated, the sooner you can find a little relief of their symptoms.

Causes

For many people, there is more than one of the causes of fecal incontinence.

The causes may include:

Diarrhea and constipation. Very soft and very hard stool may lead to fecal incontinence. The problems include:

  • Loose or watery stool that quickly fills the rectum and is difficult to maintain.
  • Large, hard stool that blocks the rectum and the results in the leakage of stool softer around her.

Damaged or weakened muscles. The muscles of the anus, rectum, and pelvic floor control of the exploitation and the passage of stool. Damaged or weakness of the muscles can cause fecal incontinence. Conditions that can weaken or damage to the muscles, which include:

  • Injuries during vaginal delivery, especially forceps.
  • Surgical incision of the vagina during childbirth, called an episiotomy.
  • Injuries, surgery, or radiation therapy.
  • Age-related weakening of the muscles.

Disorders of the nervous system. Injury or disease can affect how the nerves and muscles of the anus, rectum or pelvis of work. Disorders of the nervous system can also affect a person's awareness of the need to defecate. These conditions may include:

  • Diseases of the brain, Parkinson's disease, Alzheimer's disease or other dementias, stroke, or cerebral palsy.
  • Long-term diseases that affect the function of the nerve, such as diabetes or multiple sclerosis.
  • Spinal cord injury or tumor.
  • Damage to the nerves during surgery.

The physical problems of the anus or rectum. Spot of the physical changes in the anus or in the rectum may contribute to fecal incontinence. These include:

  • Scarring or inflammation of the rectum — an injury or long-term disease that affects the ability of the rectum to hold stool.
  • Fall of the rectum through the anus, it is called rectal prolapse.
  • Hemorrhoids that can impede the closure of the anal muscles.
  • Protrusion of the rectum to the vagina, also called a rectocele.

Risk factors

A number of factors that may increase your risk of developing fecal incontinence, including:

  • Age. Fecal incontinence is more common in adults older than 65 years.
  • Sex. Fecal incontinence is more common in women, probably due to the potential for injury during childbirth. Hormonal treatments for menopause may also increase the risk.
  • Diseases of the digestive system. The risk of fecal incontinence is the long-term increase of the diseases that affect the intestines. These include: Inflammatory bowel disease, such as Crohn's disease.The Irritable bowel syndrome.The celiac disease.
  • The inflammatory bowel disease, such as Crohn's disease.
  • The Irritable bowel syndrome.
  • The celiac disease.
  • The Mental disability. A mental disability or dementia can affect a person's ability to the plan of using the toilet or be aware of the need to use the toilet.
  • Physical disability. A physical disability or limited mobility can make it difficult to reach the bathroom in time. An injury that caused him a physical disability can cause nerve or muscle damage that increases the risk of fecal incontinence.
  • Lifestyle factors. Lifestyle factors that increase the risk of incontinence include being overweight, not being active, smoke and drink with caffeine, and alcoholic beverages.
  • The inflammatory bowel disease, such as Crohn's disease.
  • The Irritable bowel syndrome.
  • The celiac disease.

Complications

The complications of fecal incontinence can include:

  • The emotional distress. Many people feel embarrassed about fecal incontinence. And often suffer from anxiety or depression. They may try to hide the problem and avoid social situations.
  • Tissue irritation. The skin around the anus is delicate and sensitive. The repeated contact with the fecal matter can lead to pain and itching. Sores, called ulcers may appear in the tissues of the rectum.

Prevention

Depending on the cause, it may be possible to improve or prevent fecal incontinence. These actions may help:

  • Reduce the constipation. Increase the exercise, eat more foods rich in fiber and drink plenty of fluids.
  • The Control of diarrhea. Avoid foods or drinks that can worsen the diarrhea, such as drinks with caffeine, alcohol, dairy products and fatty foods.
  • Do not strain. Straining during bowel movements, eventually, may weaken the muscles of the anal sphincter or cause damage to the nerves.

Diagnosis

Your health care professional will ask about your symptoms, diet, and medical history. A detailed medical examination will include:

  • Anal and rectal exam. Your health professional will look at and examine the area around the anus to look for the reflexes of the muscles of the anus, and look for signs of irregularities in the tissues. An examination with a gloved finger inserted into the anus can detect problems with muscles, or other tissues of the rectum. The presence of hard stool and can also be detected.
  • Neurological examination. This test assesses the general state of health of the nervous system, such as the sensitivity, reflexes, coordination and balance.

Tests of rectal and anal function

Testing to see how they are able to pass stool are:

  • The anorectal manometry. A narrow, flexible device that is inserted into the anus and rectum. The test provides information about the way that the muscles and nerves of the anus and rectum of work. It also measures how much of the rectum can be extended.
  • Balloon expulsion test. A small balloon is inserted into the rectum and filled with water. Then you will be asked to go to the bathroom to expel the balloon. This test shows how well you can empty the stool from the rectum.

Imaging tests

Tests to visualize the rectum and the colon are:

  • Endoscopy. A flexible tube with a camera is used to examine the rectum and the colon. The variations of this test can be used to view only the rectum, the lower part of the colon or the entire colon. Endoscopy may show signs of inflammation, cancer or irregular tissue.
  • Endoscopic ultrasound. This device combines endoscopy and ultrasound imaging to examine the tissues of the rectum and colon.
  • Defecography. This test can be done with the images of X-ray or nuclear magnetic resonance (NMR). The test is performed with special equipment that allows imaging while they are out of step stool. This provides information on the physical condition and function of the rectum and the anus.
  • Anorectal magnetic resonance imaging. An mri can also provide information on the condition of the muscles of the anus and rectum.

Treatment

The goals of therapy are to manage conditions that cause or worsen fecal incontinence and improve the function of the rectum and the anus.

Diet and lifestyle changes

The first step is to make changes in the diet and habits of life. These may include:

Add more high-fiber foods gradually, such as:

  • Vegetables and most fruits.
  • Whole-grain foods.
  • Beans and other legumes.

Avoid foods that can cause diarrhea. These include:

  • Drinks with caffeine, alcohol or artificial sweeteners.
  • Fatty foods and dairy products.
  • The food with the addition of fructose or natural high-fructose, such as apples, peaches and pears.
  • Spicy foods.

To make other healthy changes in behavior, such as:

  • Exercising on a regular basis.
  • Drink lots of water.
  • To lose or control your weight.
  • Quit smoking.

Medications

Your health care professional may recommend medications or supplements for the treatment of conditions associated with fecal incontinence. These include:

  • The anti-diarrheal medications such as loperamide (Imodium a-D), diphenoxylate and atropine (Lomotil), and bismuth subsalicylate (Pepto-Bismal, Kaopectate, other).
  • Fiber supplements , such as methylcellulose (Citrucel) and psyllium (Metamucil, Konsyl, other), if chronic constipation is the cause of your incontinence.
  • Laxatives that help with the passage of fecal matter are the magnesium hydroxide (Phillips' Milk of Magnesia, Dulcolax Liquid, others), polyethylene glycol (MiraLAX) and bisacodyl (Correctol, Dulcolax Laxative, other).

Exercise and training

The exercises help to strengthen the muscles of the anus, rectum, and pelvic floor. These exercises can improve your control over the time of passing stool. The options include:

  • Kegel exercises. These exercises strengthen the muscles of the anus and the pelvic floor muscles. Contract the muscles you use to stop the passage of gas or urinate. Hold the contraction for three seconds, then relax for three seconds. Repeat this pattern for 10 to 15 times. As your muscles strengthen, hold the contraction more. Gradually work your way up to three sets of 10 to 15 contractions every day.
  • Biofeedback training. Specially trained physical therapists provide exercises and information. Monitoring devices to provide feedback that you can see or hear to help you understand the feelings and the muscle activity required to control the passage of stool. Biofeedback training can help you: Strengthen the anal and pelvic floor muscles.Sense when the stool is ready to be released.Contract the muscles when you need to delay defecation.
  • Strengthen the anal and pelvic floor muscles.
  • Sense when the stool is ready to be released.
  • Contract the muscles when you need to delay defecation.
  • Bowel training. Your doctor may recommend a bowel movement in a specific time of the day, such as after a meal. After a schedule for using the potty can help you get a better control.
  • Strengthen the anal and pelvic floor muscles.
  • Sense when the stool is ready to be released.
  • Contract the muscles when you need to delay defecation.

Other treatments

Other treatments may be used when more conservative treatments do not work. These include:

  • Agents of charge. Injections of non-absorbable agents of load can thicken the walls of the anus. This helps to prevent leaks.
  • Sacral nerve stimulation. The sacral nerves run from the spinal cord to the muscles of the pelvis. That regulate the feeling, and the strength of your rectum and the anal sphincter muscles. The implant a device that sends small electrical impulses to the nerves can improve the way in which these muscles work.
  • Inserted devices. An anal plug is a disposable device that is used to block the leakage. A vaginal insert is an inflatable balloon that puts pressure on the lower part of the rectum to prevent leakage.

Surgery

Surgery may be needed to correct an underlying problem, such as prolapse of the rectum, which causes fecal incontinence. The surgery is also used when other treatments do not work. The options include:

  • The surgery for the underlying problems. Surgery can repair the tissues that cause or contribute to fecal incontinence. These include rectal prolapse, a rectocele, or hemorrhoids. These surgeries may be necessary for the life-style of the treatments and medications for the job.
  • Sphincteroplasty. This procedure repairs damaged or weakened anal sphincter that occurred during the delivery. Doctors identify an area of the muscle injury and free edges of the surrounding tissues. That, then, wear the muscle edges back together and sew in an overlapping fashion. This helps to strengthen the muscle and tighten the sphincter. The procedure does not always work, and the benefit decreases with time.
  • Colostomy, also called bowel diversion. This surgery is diverted from the feces through an opening in the abdomen. Doctors attach a special bag for this opening to collect the stool. The colostomy is used after other treatments have not been successful.

Lifestyle and home remedies

Daily

Take daily for a couple of weeks can help manage symptoms and communicate with your health care professional. Consider the following:

  • Food journal. Write down what you have for the meals, snacks and drinks. You can discover a pattern between certain foods and fecal incontinence. Once you have identified the problem of food, stop eating, and see if the problem improves.
  • Stool diary. Write to the passage of stool, and when you experience incontinence. Also, note that the stool is like the. Your health care professional can provide you with a photo of the table to help you to describe the stool.

Skin care

You can help to avoid more discomfort, fecal incontinence, keeping the skin around the anus that is as clean and as dry as possible. To relieve the discomfort of anal and get rid of the odors associated with fecal incontinence:

  • The use of wipes fragrance free. The use of scent-free, alcohol-free wipes rather than dry toilet paper after a bowel movement.
  • Wash with water. Gently wash the area around the anus with water and scent-free soap after defecation or an episode of incontinence. Take a shower or bath may also help.
  • Dry well. Allow the area to air dry, if possible. If you're short on time, you can gently pat the area dry with toilet paper or a clean towel.
  • Apply a cream or powder. The moisture barrier creams to help maintain skin that is irritated from having direct contact with the feces. Make sure that the area is clean and dry before applying any cream. Nonmedicated baby powder or corn starch can also help to relieve the discomfort of the anal.
  • Wear cotton underwear and loose clothing. Tight clothing can restrict the flow of air, causing the skin problems worse. Change of underwear dirty quickly.

When medical treatment cannot completely eliminate incontinence products such as absorbent pads and disposable underwear can help you manage the problem. If you use pads or adult diapers, make sure that you have an absorbent wicking layer on the top. This helps to keep the moisture away from your skin.

Coping and support

For some people, including children, fecal incontinence is a relatively minor problem. It is usually limited to occasional soiling his underwear. For others, the condition can be more difficult, a permanent condition.

If you have fecal incontinence

You may feel reluctant to leave his house because you are worried about what is a bathroom in time. Try these tips:

  • Use the toilet just before you leave.
  • If you expect that you are going to be incontinent, use a heating pad or disposable underwear.
  • Bring cleaning supplies and a change of clothes.
  • Know where the bathrooms are located before you need them. This can help you to quickly access them.
  • Use non-prescription pills to reduce the odor of feces and gases. These are known as fecal deodorants.

Due to the fecal incontinence can be distressing, it is important to take measures to deal with it. The treatment can help to improve their quality of life and raise their self-esteem.

Preparing for your appointment

You can start by seeing your primary healthcare professional. Then, you may be referred to a provider who specializes in the treatment of digestive conditions, called a gastroenterologist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test. Make a list of:

  • Your symptoms , including any that seem unrelated to the reason for your appointment.
  • Key personal information , including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you are taking, including the dosage.
  • A family member or a friend with you if possible, to help you remember the information they give you.
  • Make a list of questions to ask during the appointment.

For fecal incontinence, some basic questions to ask include:

  • What is likely causing my symptoms?
  • Other that the most likely cause, what are other possible causes of the symptoms?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. Treatment for fecal incontinence complicate my attention to these conditions?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

What to expect from your doctor

Your provider is likely to ask several questions, such as:

  • When did your symptoms begin?
  • The symptoms been continuous or come and go?
  • How severe are the symptoms?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Avoid any activity because of your symptoms?
  • Do you have other conditions such as diabetes, multiple sclerosis or frequent constipation?
  • Do you have diarrhea?
  • Have you ever been diagnosed with a disorder of the colon?
  • Have you ever had radiation therapy to the pelvic area?
  • Were forceps used or have you had an episiotomy during delivery?
  • Do you also have urinary incontinence?

What you can do in the meantime

Do not eat food or do the activities that make your symptoms worse. This could include avoiding caffeine, fatty or greasy foods, dairy products, spicy foods, or anything that makes the problem worse.

Symptoms and treatment of Fecal incontinence