Fecal Incontinence


Other Names:Bowel Control Problems, Bowel Incontinence

Description:
Fecal Incontience is the inability to control bowel movements. It’s a common problem, especially among older adults.

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Accidental bowel leakage is usually not a serious medical problem. But it can seriously interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment.

Symptoms:
The symptoms of fecal incontinence include a strong urge for a bowel movement and not being able to control it, and passing solid or liquid stool without knowing it.

Causes:
Fecal incontinence has many causes, including digestive tract disorders and chronic diseases. The most common cause is damage to the muscles around the anus (anal sphincters). Vaginal childbirth can damage the anal sphincters or their nerves. That’s why women are affected by accidental bowel leakage about twice as often as men.

Anal surgery can also damage the anal sphincters or nerves, leading to bowel incontinence.

There are many other potential causes of bowel incontinence, including:

*Diarrhea (often due to an infection or irritable bowel syndrome)

*Impacted stool (due to severe constipation, often in older adults)

*Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

*Nerve damage (due to diabetes, spinal cord injury, multiple sclerosis, or other conditions)

*Radiation damage to the rectum (such as after treatment for prostate cancer)

*Cognitive (thinking) impairment (such as after a stroke or advanced Alzheimer’s disease)

More than one cause for fecal incontinence is frequently present. It’s also not unusual for bowel incontinence to occur without a clear cause.

Diagnosis:
Discussing fecal incontinence may be embarrassing, but it can provide clues for a doctor to help make the diagnosis. During a physical examination, a doctor may check the strength of the anal sphincter muscle using a gloved finger inserted into the rectum.

Doctors use your medical history, a physical exam, and tests to diagnose fecal incontinence and its causes. Your doctor will ask specific questions about your symptoms. Play an active role in your diagnosis by talking openly and honestly with your doctor.

Other tests may be helpful in identifying the cause of bowel incontinence, such as:

Stool testing. If diarrhea is present, stool testing may identify an infection or other cause.

Anorectal manometry: A pressure monitor is inserted into the anus and rectum. This allows measurement of the strength of the sphincter muscles.

Endosonography: An ultrasound probe is inserted into the anus. This produces images that can help identify problems in the anal and rectal walls.

Nerve tests: These tests measure the responsiveness of the nerves controlling the sphincter muscles. They can detect nerve damage that can cause bowel incontinence.

MRI defecography: Magnetic resonance imaging of the pelvis can be performed, potentially while a person moves her bowels on a special commode. This can provide information about the muscles and supporting structures in the anus, rectum, and pelvis.

Complications:
Complications of fecal incontinence may include:

Emotional distress: The loss of dignity associated with losing control over one’s bodily functions can lead to embarrassment, shame, frustration, anger and depression. It’s common for people with fecal incontinence to try to hide the problem or to avoid social engagements.

Skin irritation: The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to pain and itching, and potentially to sores (ulcers) that require medical treatment.

Treatment:
Many effective treatments can help people with bowel incontinence. These include:

*Medicine

*Surgery

*Minimally invasive procedures

Talking to your doctor is the first step toward freedom from fecal incontinence.

Dietary changes:
What you eat and drink affects the consistency of your stools. If constipation is causing fecal incontinence, your doctor may recommend drinking plenty of fluids and eating fiber-rich foods. If diarrhea is contributing to the problem, high-fiber foods can also add bulk to your stools and make them less watery.

Exercise and other therapies:
If muscle damage is causing fecal incontinence, your doctor may recommend a program of exercise and other therapies to restore muscle strength. These treatments can improve anal sphincter control and the awareness of the urge to defecate. Options include:

Biofeedback: Specially trained physical therapists teach simple exercises that can increase anal muscle strength. People learn how to strengthen pelvic floor muscles, sense when stool is ready to be released and contract the muscles if having a bowel movement at a certain time is inconvenient. Sometimes the training is done with the help of anal manometry and a rectal balloon.

Bowel training: Your doctor may recommend making a conscious effort to have a bowel movement at a specific time of day: for example, after eating. Establishing when you need to use the toilet can help you gain greater control.

Sacral nerve stimulation (SNS): The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Implanting a device that sends small electrical impulses continuously to the nerves can strengthen muscles in the bowel. This treatment is usually done only after other treatments are tried.

Posterior tibial nerve stimulation (PTNS/TENS): This minimally invasive treatment may be helpful for some people with fecal incontinence, but more studies are needed.

Vaginal balloon (Eclipse System): This is a pump-type device inserted in the vagina. The inflated balloon results in pressure on the rectal area, leading to a decrease in the number of episodes of fecal incontinence. Results for women have been promising, but more data are needed.

Doing regularly Yoga & Meditation under a trained person totally cures the  fecal incontinence.

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

*Reduce constipation:  Increase your exercise, eat more high-fiber foods and drink plenty of fluids.

*Control diarrhea:  Treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid fecal incontinence.

*Avoid straining: Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.webmd.com/digestive-disorders/bowel-incontinence#2
https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence
https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/diagnosis-treatment/drc-20351403

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