Faecal incontinence - fecal incontinence
Encyclopedia Symptoms / / April 24, 2016
Alternative names: fecal incontinence;uncontrolled defecation;loss of control over bowel;bowel incontinence;inability to control the act of defecation, stool or anal incontinence.
faecal incontinence is the inability to control the ability to hold and control the passage of gas and stool from the anus, in other words - the loss of control over bowel that leads to the involuntary passage of feces.Leaking small amounts of stool and associated gas from time to time can cause a complete loss of control of defecation.
order to maintain abstinence chair - the rectum, anus, pelvic muscles and the nervous system - all this must be normal and well functioning.Man must also have the physical and mental abilities (intact brain) to recognize and respond to the urge to defecate.
Incontinence chair - quite a common problem, but due to the existing social prejudice with her patients rarely go to the doctor and are embarrassed to talk about it.
Most bowel examinations in people over 65 years found that women ex
- chronic constipation, causing the muscles of the anus and intestines can stretch and weaken, leading to leakage of stool, diarrhea;
- constant use of laxatives;
- colectomy (bowel surgery);
- reducing feelings of rectal fullness (the sensation of complete emptying of the bowel);
- emotional problems, stress or depression;
- gynecological problems or rectal surgery;
- women perineal trauma during birth;
- anal muscle injury;
- decreased tone muscles of the perineum;
- some women - damage to the anal muscles for childbirth;
- muscle and nerve damage (trauma, tumor or radiation);
- severe diarrhea, which suppresses the ability to control the passage of stool;
- strong hemorrhoids or rectal prolapse;
- stress due to the unfamiliar environment.
The patient must inform the doctor about any problems with bowel incontinence.Especially if:
- a child who is trained properly to go the toilet, has any fecal incontinence;
- adult has fecal incontinence;
- the patient has a skin irritation or injury as a result of a bowel movement.
doctor makes the patient diagnostic examination, focusing on the stomach and rectum.It will be carried out inspection of the rectum and the anus of the patient doctor thumb: physician inserts a lubricated medical ointment finger into the rectum to assess the state of sphincter tone, anal reflexes, and to check for abnormalities in the rectum.
doctor may wish to check with the following important aspects of the patient:
- when the patient is bowel incontinence;
- how long were these problems;
- how many times it happens every day;
- whether the patient is aware of the need to defecate before the leakage occurs;
- what is the consistency of the stool of the patient;
- it is hard, soft or liquid stool;
- describe the amount of leakage of the chair (with the gas without gas, with a large number of feces);
- could it recently something to cause emotional distress in a patient;
- if the patient has thoughts of confusion or disorientation;
- if it is a child, if he is trained (it) proper circulation in the toilet and whether he (her) problems with toilet training;
- What other symptoms are present;
- what operations have been patient;
- what the injuries were patient;whether he (or rather she) obstructed labor;
- what medications the patient takes;
- how much the patient drinks coffee;
- whether the patient consumes alcohol, if so, how much;
- the usual diet of the patient.
Diagnostic tests may include:
- X-rays with a barium enema;
- blood tests;
- electromyography (EMG);
- rectal ultrasound or pelvic ultrasound;
- seeding feces;
- test anal sphincter ( "anal manometry," or "anorectal manometry" - functional diagnostic study anorectal area to obtain information about the anorectal muscle tone complex and coordinated contractions of the rectum and anal sphincters);
- X-ray procedure using a special dye to evaluate how well the sphincter works (balloon sfinkterogramma);
- X-ray procedure using a special dye to see the intestines during bowel movements (defekografiya or evacuation proktografiya - a method of X-ray examination, which allows you to visually assess the state of the rectum and anal canal, as well as functional disorders of emptying the rectum, it is difficult to identify otherImaging methods).
treatment of anal incontinence
Incontinence is not a hopeless situation.Proper treatment can help most people and can often fix the problem.
Treatment of bowel incontinence should begin with identifying its causes (or several reasons).There are several ways to strengthen the anal and pelvic muscles, which contributes to normal bowel function.
Fecal usually caused by chronic constipation, which partially blocks the colon.If constipation or large stool contribute to fecal incontinence, as a rule, laxatives and enemas are of little help.Your doctor may insert one or two fingers into the rectum and break the stool into smaller pieces that can pass more easily.
measures to prevent further accumulation of feces: add to your diet more fiber (fiber) to help form normal stool.It is necessary to use other medicines that the doctor will recommend.In addition, you must drink plenty of fluids and getting enough exercise to enhance normal stool consistency.
- Diet. bowel movements often arise due to the fact that the rectal sphincter is less capable of handling large amounts of loose stool.Often, simply changing the occurrence of bowel incontinence can be reduced diet.
is not recommended to drink alcohol and caffeine because many people, they can cause diarrhea and incontinence.Some people develop diarrhea after consuming milk products, because they are unable to digest lactose or sugar found in most dairy products.Some food additives - such as nutmeg and sorbitol - some people may cause diarrhea.
Adding food volume can contribute to thickening of loose stool and reduce its weight.Increased fiber (at least 30 grams per day) of whole grain wheat and bran - add the amount of food.Also useful plantain.
- Medicines. In people with bowel incontinence due to diarrhea medication such as loperamide (Imodium) can be used to control diarrhea and improve bowel movement.
Other antidiarrheal agents include anticholinergic drugs (belladonna or atropine) that reduce intestinal secretion and motility (movement) of the intestine.Opium derivatives (analgesic or codeine) or diphenoxylate (Lomotil), as well as loperamide (Imodium), increase intestinal tone and reduce bowel movement.
Other medications used to control bowel movements, include drugs that reduce the water content in the stools (activated carbon or Kaopectate) or those that absorb the liquid and add the amount of stool (eg Metamucil).
patient should consider and check all the medicines he takes, together with your doctor.
Some medications can cause or increase bowel incontinence, especially in the elderly.These medications include:
- other therapy.
If the patient has frequent bowel incontinence, he can use a special device - fecal collections that retain fecal incontinence and protect the skin.These devices consist of a drainage bag attached to the adhesive plate (this plate ensures reliable fixing stoma bags on the anterior abdominal wall for several days following the bending of the body).The plate has a hole in the center through which they put on the anus.
Most people with bowel incontinence due to lack of control of the sphincter or reduce awareness of the urge to defecate can benefit from for your bowel retraining program and special medical gymnastics, helps restore normal muscle tone.
Particular attention should be paid to the maintenance of bowel control in people who have a reduced ability to recognize the urge to defecate, or those who have limited mobility, not allowing them to independently and safely use the toilet.Such people should receive assistance in the toilet after meals, and promptly go to the toilet if they arise urge to defecate.
If you walk to the bathroom needs are often left without satisfaction, that a person may develop a "pattern of negative reinforcement."In this case, he can no longer take the right actions, when he feels the urge to defecate.
- Surgery. People who have a bowel movement, continuing even with treatment, can benefit from the surgery, which will help get rid of the problem.There are several different options.Choosing surgery option is based on the cause of bowel incontinence and the person's general health.
- Direct sphincter. sphincter treatment is performed on people whose anal muscle ring (sphincter) does not work well due to injury or aging.The procedure consists of repeated, more effective, join the sphincter of the anus.
- artificial bowel sphincter. Some patients can be treated with an artificial bowel sphincter.It consists of three parts: a cuff, which is located around the anus of the balloon for controlling the pressure and a pump which pumps the cuff.
implanted artificial sphincter around the rear of the sphincter.The cuff is higher and supports abstinence.The patient defecates by deflating the cuff.Cuffs are automatically re-inflated after 10 minutes.
- colostomy. sometimes fecal leakage occur in people who do not help the different treatments.Colostomy - when the colon is attached to the opening in the abdominal wall.Stool passes through the hole in a special bag.The patient will need to use colostomy - bag to collect stool, the open end of the colon, put into the anterior abdominal wall, and fortified it by surgical methods for the release of feces and intestinal gas.Colostomy placed not only in colon cancer, but also in patients with injuries of the colon and in various other disorders: ulcerative colitis, Crohn's disease, colonic polyposis total and others.