What is Fecal Incontinence?
What is Fecal Incontinence? Fecal incontinence is reduced or lost intestine (gastrointestinal) control over the process of ‘digesting’ waste out of the body through the rectum. This condition results in the release of various types of impurities by itself. This dirt consists of several types, namely gas (farts), mucus, and stools that are liquid or solid.
Causes of Fecal Incontinence
Fecal incontinence can be caused by muscle, nerve, or some other medical condition. This condition is more a symptom than as a diagnosis of a disease. Here are some causes, including risk factors that can put a person at risk for stool incontinence.
- Nerves or damage to the nerves that control the anal sphincter due to labor, excessive stretching during bowel movements, strokes, or spinal cord injuries. Some diseases may also cause neurological disorders, such as diabetes and multiple sclerosis.
- Damage to the circle of muscle located at the end of the anal oral (anal sphincter). This disorder can start from labor due to an episiotomy procedure, ie vaginal surgery when giving birth.
- Surgery to treat hemorrhoids or other conditions associated with the anus or rectum (the ultimate portion of the colon) is therefore at risk of causing nerve damage to the area.
- The rectum that goes down to the anus is called rectal prolapse.
- The rectum protrudes outward into the vaginal area of the female or is called the rectocele.
- Limited space in the rectum to accommodate impurities caused by scarring of the rectal wall that reduces rectal flexibility. This condition is usually caused by surgery, a disease that causes inflammation of the gastrointestinal tract, or radiation therapy.
- Chronic constipation that affects the hardening of the dirt makes it difficult to pass through the rectum and is removed from the body. The process of removing hard dirt will affect the nerves and muscles of the rectum or intestine that cause the dirt in the form of fluid through hard dirt and eventually out of the digestive tract.
- Diarrhea in the form of liquid stool risk exacerbate fecal incontinence compared to more dense stools.
- Stool incontinence is more common in middle-aged and elderly people.
- Patients with Alzheimer’s and dementia also have an increased risk of fecal incontinence.
- This condition is also commonly experienced by women, especially due to complications of childbirth. However, this condition can not cause symptoms for years. Generally, this condition arises when a woman is 40 years old.
- People who have physical limitations due to injury and damage to the rectal nerves or other body parts are also at risk of stool incontinence. Physical limitations will also make it difficult when to go to the toilet. The body that is inactive for too long will also trigger constipation and again lead to stool incontinence.
Symptoms of Fecal Incontinence
Stool incontinence is experienced differently in each person. There are those who experience it every day, but some are experiencing it at certain times only. Some patients may also be unaware of the seepage because they do not feel the symptoms or sensations want to defecate at all. This condition is called passive incontinence.
Other patients experience fecal incontinence while experiencing diarrhea or have cases when the disease is repeated more than once. They have difficulty withholding the urge to have a sudden bowel movement, also called urgent incontinence.
Of the two types of incontinence above, it can be said that fecal incontinence can be accompanied by symptoms of gastrointestinal disturbances, such as:
- Bloated stomach contains gas
Diagnosis Fecal Incontinence
Preliminary examination performed to diagnose fecal incontinence begins with a physical examination first, one of them by looking directly at the condition of the patient’s anus. Doctors can use a hand or a blunt-ended tool to detect any nerve damage in the area. The response is usually a contraction of the anal sphincter and the anus slightly juts out.
Possible tests performed after initial examination to ascertain the cause of fecal incontinence in patients are:
- Digital rectal examination by inserting a gloved finger glove and lubricating to evaluate the strength of anal sphincter muscle and disturbance around the rectal. Patients will also be told to push to find out if the rectal prolapse (rectal prolapse).
- Proctography, which takes X-ray video from the patient during defecation in the toilet specially designed to measure how much dirt that can be released by the body. This test is also done to determine the strength of the rectum to hold dirt so as not to seep.
- MRI body imaging test to get a clearer picture of anal sphincter and see if the anal muscle is still intact. This test is also done to get an overview of the sewerage process.
- Anorectal ultrasound to see the sphincter structure of the patient by inserting a surgical instrument that resembles a thin stick to the anus and rectum.
- Proctosigmoidoscopy, ie insert a flexible tube into the rectum to check the intestine closest to the rectum (about 60 cm) if there is inflammation, scarring, or tumor. This condition can be a cause of fecal incontinence.
- Colonoscopy procedure to check all parts of the intestine by inserting a flexible tube into the rectum.
Treatment of Fecal Incontinence
Stool incontinence is treated according to the condition of the cause. The types of treatment of this disease include the provision of drugs, surgery, dietary changes to various therapies.
There are several types of drugs that may be given to people with fecal incontinence, such as:
- Antidiarrheal drugs : For example diphenoxylate, atropine sulfate, and loperamide hydrochloride.
- Laxatives in large quantities : For fecal incontinence caused by chronic constipation. It has psyllium, or methylcellulose.
- Collecting agents injected into the anal canal : For example Hyaluronate Sodium solution.
An operative procedure may be performed to treat the cause of fecal incontinence caused by another medical condition, such as rectal loss and rectal muscle damage due to labor. Some common procedure options are:
- Corrective surgical procedure : Treating rectal, rectocele, and hemorrhoids. This procedure will help reduce or eliminate fecal incontinence.
- Sphincteroplasty : Surgical procedures to repair weak or damaged rectal muscles are common in stool incontinence patients after delivery.
- Colostomy : The procedure of transferring the dirt to the opening made in the abdominal area. The dirt will come out through this hole and will be accommodated in a special bag attached near the hole.
Basically, this procedure is performed only if other methods do not work.
- Physical therapy
Physical therapy can also help restore damaged rectal muscle strength. In addition, therapy can also increase the control and vigilance of anal muscles against the desire to urinate. Some therapies that are usually recommended for people with fecal incontinence, namely:
Stimuli of the sacral nerve
The continuous implanting of electrical impulse transmitters in the sacral nerve, which can strengthen the rectal muscle. The sacral nerve lies along the spinal cord to the muscles in the pelvic bone and controls the sensation and strength of the rectal muscles and rectal muscles. This procedure is usually done as a last treatment option.
This pump-like instrument is inserted into the vagina to put pressure on the rectal area as it expands and reduces the frequency of urination resulting from fecal incontinence.
A simple exercise movement to increase the strength of the rectal muscles, pelvic floor muscles, muscle contractions while urinating, and sensations when the dirt is ready to be removed from the body. A therapist will help people with fecal incontinence to study these movements with the help of anal or rectal balloon.
Train the gut or gastrointestinal tract
Having a habit of defecating at certain times will increase the body’s control over the condition of faecal incontinence experienced, such as defecation after eating.
This exercise can reduce fecal incontinence and strengthen the pelvic floor muscles that play a role in urinary tract, gastrointestinal, and female uterine performance. Kegels are performed by producing contractions in the muscles normally used to stop the flow of urine for three seconds, then relax for three seconds. Do this pattern ten times.
Next you can increase the duration of contraction and the number of patterns gradually when the muscle is getting stronger.
- Dietary changes in food consumed. Food and beverages are very influential on the body so reducing or adding certain types of foods or beverages can help reduce the incontinence of the stools experienced. Usually doctors will recommend patients to consume lots of fluids and foods high in fiber to people with fecal incontinence due to constipation. As for patients who are caused by diarrhea, consuming high fiber foods can also condense stools.
- Drink at least eight glasses of water a day.
- High-fiber foods are usually found in fruits and vegetables. Get used to eating foods high in fiber as much as 20-30 grams a day, but do it gradually and adjust to the condition of the body to avoid bloating or gas containing stomach.
- Changing your diet can also help you control the movement of the gastrointestinal tract and sewage process. Watching anything that is consumed will help you make notes containing foods or drinks that should be reduced or added from the daily diet list. Spicy, fatty, oily, bersantan, and dairy foods are some foods to avoid, as well as soft drinks. Ask your doctor or nutritionist about the list of foods or beverages that need attention.
- Keeping the skin clean around the anal canal and making sure it stays dry. Rinse the anal area cleanly after each bowel movement, then dry thoroughly. Avoid using cleansing soaps as they may cause irritation. You can use a moistened-free tissue or a liquid-free cloth for wiping the anal area. Cream or powder that does not contain many chemicals can also be used to reduce discomfort around the area of the anus. You can also use adult pads that are able to absorb moisture in a closed area.
- Use cotton underwear to keep the air flow awake. Replace wet clothes as soon as possible to avoid discomfort or irritation. Underwear in disposables can be used.
Patients with fecal incontinence usually experience problems with confidence and difficulty while outdoors. Here are some things that can be done by people with fecal incontinence to maintain comfort and increase confidence related to the condition suffered.
- Piss off before traveling.
- Use sanitary napkins or diapers when traveling long distances.
- Do not forget to prepare a cleaning tool and change clothes as needed.
- Immediately find the location of the toilet when he arrived at the destination.
- Use the deodorizing pills to reduce the unpleasant smell of dirt or gas (farts). Such pills can be obtained at the pharmacy.
Complications of Fecal Incontinence
Fecal incontinence not only causes irritation of the skin around the smooth and sensitive anus. Other complications if these conditions are not treated immediately, namely:
- Injuries or ulcers
- The incidence of anger
- Shame and alienation to hide this problem from its environment
Prevention of Fecal Incontinence
Fecal incontinence is a condition that can not be cured easily because it will be determined to the type of cause. However, the following steps can be taken to help anticipate the development of stool incontinence conditions.
- Avoid straining during bowel movements. Mengejan can weaken the rectal muscle or damage the nerves that can lead to fecal incontinence.
- Avoid the causes of diarrhea.
- Reduce the cause of constipation, for example by eating foods high in fiber, drink lots of fluids, and exercise regularly.