Fecal incontinence

Overview

Fecal incontinence, or also called bowel incontinence, is the inability to control bowel movements. The rectum leaks stool (feces, waste, or excrement) when least expected, even if it is not during bathroom breaks. This condition could also leak stool even if just releasing gas until uncontrollable bowel movements.

As the muscle or nerve injury may be related to aging or giving birth, it is common in elderly. Fecal incontinence is frequently brought on by muscle or nerve injury, constipation, and diarrhea.

The following are two types of fecal incontinence:

• Urge incontinence: refers to the condition that cannot control the urge to defecate.
• Passive incontinence: refers to the condition that the person does not realize that they need to defecate.

Fecal incontinence typically does not cause major health issues, but it can significantly interfere day-to-day living. Fecal incontinence can be challenging to talk about, regardless of the cause. It is recommended to discuss the condition to the healthcare provider. Treatments can enhance the quality of life and reduce fecal incontinence.

Symptoms

Bowel incontinence may be a temporary issue or a recurring one. Occasionally having diarrhea might lead to fecal incontinence. But fecal incontinence occurs frequently for some persons. Other bowel issues, such as:

• Diarrhea, loose watery stool.
• Constipation, problem passing stool.
• Gas and bloating.

If the patient or the baby have fecal incontinence and had been severe that resulted to mental discomfort, it is recommended to seek medical help. People may feel too ashamed to disclose fecal incontinence to healthcare provider. However, the sooner they are assessed, the sooner they might see some symptom to be treated.

Causes

Fecal incontinence can have more than one probable cause. These are some of the potential causes:

• Diarrhea: Loose stools from diarrhea might aggravate or cause fecal incontinence because they are harder to keep in the rectum than solid stools.
• Constipation: A dry, hard lump of stool that has become too big to pass may form in the rectum as a result of chronic constipation. Constipation for an extended period of time might harm nerves, which can result in fecal incontinence.
• Muscle damage: When healthcare provider uses forceps or make a little cut (an episiotomy) to create a bigger opening during a challenging vaginal delivery, muscle injury may result. Anal or rectal surgery can also potentially cause muscle injury. This resulted in difficulty to hold stools if the muscle at the end of the rectum are injured.
• Nerve damage. Incontinence may occur if the nerves that controls the rectum and anus muscles are damaged. Incontinence can also result from impaired “rectal sensory” nerves. Constipation (which causes episodes of frequent and intense straining) can cause nerve injury, as can the presence of certain medical disorders, difficult vaginal deliveries, anal surgery, and certain health issues (such as diabetes, multiple sclerosis, stroke or a spinal tumor).
• Reduced rectum storage capacity: The rectum typically expands to make room for the stool. Excess feces can leak out if the rectum cannot extend as much as it needs which could due to scarring or stiffness. The rectum may become tight and scarred as a result of surgery, radiation therapy, or inflammatory bowel disease.
• Surgery: Fecal incontinence can be brought on by rectal and anal surgeries, such as those performed for hemorrhoids, which can harm muscles and nerves.
• Other health conditions:
  • Rectal prolapse: Fecal incontinence may develop as a result of rectal prolapse, a disorder in which the rectum descends into the anus. The nerves that control the rectal sphincter are damaged as a result of the rectal sphincter being stretched by prolapse.
  • Rectocele: Fecal incontinence in females can happen if the rectum pokes through the vagina.
  • Hemorrhoids: Stool may seep out of the anus as a result of these enlarged veins, preventing it from shutting entirely.

Risk factors

The chances of developing fecal incontinence may be affected by a number of factors, including:

• Age: Fecal incontinence is more common in individuals over the age of 65, but it can occur at any age.
• Gender: Women are more prone to develop fecal incontinence because a small increase has been discovered in recent research among women who use menopausal hormone replacement treatment. Childbirth complications including fecal incontinence are possible.
• Nerve damage: Fecal incontinence may occur in people with long-term diabetes, multiple sclerosis, or spinal damage after injury or surgery. The nerves that help regulate defecation may be harmed by certain disorders.
• Physical disability: Fecal incontinence can result from a traumatic injury that damages the rectal nerves. Being physically disabled could be challenging to get to the bathroom in time.
• Dementia: Dementia and late-stage Alzheimer’s disease, fecal incontinence is frequently observed.