Faecal incontinence

Uncontrolled fecal loss

Faecal incontinence is an unpleasant defecation disorder that consists in the involuntary and uncontrolled loss of stool and intestinal gas.

More than a disease itself, fecal incontinence should be considered a very unpleasant symptom that unites countless and heterogeneous pathologies, ranging from diarrhea to constipation, from neurological disorders to birth injuries.
The severity of the disorder is linked to the cause that induced it: in fact, fecal incontinence varies from an occasional and modest loss of stool to a total lack of control of the anal sphincter.
Regardless of the cause and severity of the disorder, fecal incontinence is always and in any case a humiliating condition, which severely limits the patient's recreational, social and work activities, with inevitable loss of self-esteem. For this reason, it is important that the patient speaks to his doctor from the very first symptoms; in fact, there are numerous and valid therapeutic options that can significantly improve the problem and the quality of life.

Causes

The list of triggers for faecal incontinence is quite long. The most frequent are listed below:

1. DISORDERS OF DEFECATION
   Faecal incontinence is observed with a clear prevalence in patients suffering from any defecation disorder (chronic diarrhea, acute diarrhea, constipation, etc.). Chronic constipation, for example, by compacting the stool at the rectal level, progressively weakens the rectal muscles, which causes loss of fecal control, and chronic constipation can cause damage to the nervous system, which in turn can aggravate the fecal disturbance.
   Even diarrhea, especially its chronic variant, can cause fecal incontinence: in fact, watery stools are eliminated more easily than hard stools, consequently it is not uncommon for the affected patient to lose control of the sphincters.
2. LOSS OF ELASTICITY OF THE RECTUM
   An "other cause of" € ™ fecal incontinence is to be found in the loss of elasticity of the rectum: some surgeries (eg those for the treatment of severe hemorrhoids), as well as obstetric injuries (caused by a long and difficult birth), they can stiffen the last intestinal tract, so much as to procure a total or partial inability to control the impulses to defecate. But surgical interventions are not the only ones responsible for the progressive stiffening of the rectum. In fact, even some inflammatory bowel diseases or radiotherapy treatments (for the treatment of tumors) can have the same effect.
3. URINARY INCONTINENCE
   Even people who suffer from urinary incontinence tend to develop, over time, difficulty in controlling the anal sphincter, hence fecal incontinence.
4. RECTAL PROLAPSE
   Among the other risk factors for fecal incontinence we cannot forget rectal prolapse (a portion of the rectum descends into the anus) and rectocele (the rectum protrudes through the vagina).
5. NEUROLOGICAL DISORDERS AND NERVE DAMAGE
   Sometimes, faecal incontinence is a collateral symptom of numerous neurological disorders, so much so that it can even be aggravated by the intake of certain medicinal specialties (eg laxatives).
   Injuries to the nerves that control the rectal tract and anal sphincters are also a frequent cause of fecal incontinence. These bundles of nerves can be torn or injured as a result of excessive effort during evacuation (induced for eg from fecaloma or constipation), prolonged childbirth, spinal cord injury (eg spina bifida), stroke and disabling diseases such as diabetes and multiple sclerosis.

Summary of the main causes related to fecal incontinence:

• Abuse of laxatives
• Chronic / acute diarrhea
• Emotional disorders and stress
• Chronic intestinal disorders: € ™ irritable bowel syndrome, inflammatory bowel disease
• Severe hemorrhoids
• Intestinal surgery (for example for the treatment of anal fistulas)
• Gynecological surgery (for women)
• Prostate surgery (for men)
• Food intolerance
• Disabling diseases: diabetes, multiple sclerosis
• Loss of elasticity of the rectum
• Rectal prolapse
• Chronic constipation
• Obstetric trauma (rectal injury during childbirth)

Risk factors

Female sex represents a risk factor for fecal incontinence: in fact, the condition has been observed much more in women than in men, probably because childbirth is a common trigger.
Although faecal incontinence can appear at any age, undoubtedly, senescence increases the risk exponentially. In fact, it is estimated that 1 in 10 women over 40 years of age is affected by this unpleasant and embarrassing disorder.
Another not to be underestimated risk factor for fecal incontinence is represented by dementia: many patients suffering from this disorder or Alzheimer's disease tend to progressively lose control of the anal sphincter.
Considering then that faecal incontinence is closely linked to lesions of the nerves that control the urge to defecate, it is easy to understand how some pathologies responsible for damage to the aforementioned nerve bundles increase the risk exponentially. Not surprisingly, many patients suffering from diabetes or multiple sclerosis also suffer from fecal incontinence.

Other articles on "Fecal Incontinence"

1. Faecal incontinence: symptoms, complications and diagnosis
2. Faecal incontinence: treatment, interventions and diet