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Bowel Incontinence

What is Bowel Incontinence?

It is an inability of a person to control bowel movements resulting in leakage from the rectum. It is also called faecal incontinence.  The chances of older individuals developing bowel incontinence are higher than young individuals. The degree of incontinence varies from minimum to complete loss of control. 

Causes of Bowel Incontinence

There are numerous causes of bowel incontinence. They include:

Nerve Damage: It may occur due to disorders such as multiple sclerosis, diabetes, spinal cord injuries, etc. Women are at higher risk for nerve damage during childbirth. 

The nerves that control the anal sphincter or the nerve that sense and control stools in the rectum can be damaged leading to bowel incontinence. 

Diarrhoea: It worsens the symptoms of bowel incontinence. 

Muscle Damage: Muscles of the rectum may be damaged during childbirth (women) and cause bowel incontinence.

Radiation damage: Men suffering from prostate cancer treated with radiation therapy are at greater risk of developing bowel incontinence.

Constipation: Chronic constipation causes weakening of the muscles of the rectum and nerve damage. 

Haemorrhoids: Swelling of the veins in the rectum can prevent the rectum from closing properly causing incontinence. 

Surgery: Surgery of the rectum and anus may cause tissue scarring and stiffened walls. This decreases the proper stretching of the rectum and hence leaking of stools.

Symptoms of Bowel Incontinence

Bowel incontinence may be temporary or chronic. Certain conditions such as diarrhoea may cause temporary incontinence.  Chronic bowel incontinence is when it occurs frequently. 

The symptoms include one or more of the following:

  • Uncontrolled urge to defecate
  • Loss of perception to pass stools
  • Incomplete evacuation

What Happens if Bowel Incontinence is Left Untreated?

Repeated passage of stools causes skin irritation, pain, and ulcers of the rectum and anus. The patients often feel sad and embarrassed and avoid being around people or in public places. This can lead to depression. Hence, treatment of bowel incontinence is very important to maintain a good quality of life. 

Diagnosis of Bowel Incontinence

Your doctor orders one or more of the following diagnostic tests:

Endoscopy: An endoscope is a long tube fitted with a camera on the end and is inserted into your anus to assess the reason for faecal incontinence.

Anorectal manometry: The strength of the anal sphincter (muscle) is measured. 
Endosonography: This test uses an ultrasound probe to produce images of the anus and rectum.

Stool Testing: Stools are tested in a laboratory to check for infections.
Nerve Tests: Used to diagnose damaged nerves responsible for bowel incontinence.

Treatment of Bowel Incontinence

Treatment includes both non-surgical and surgical methods.

Non-Surgical Treatment

Follow these simple ways to treat your bowel incontinence:

  • Consume more fibre-rich food
  • Consume enough water
  • Avoid caffeine intake
  • Certain medications can be prescribed to help control bowel movements
  • Specific exercises help to strengthen the anal sphincter

Surgical Treatment

You are treated surgically if you do not respond to non-surgical methods of treatment. The weakened anal muscles may be stitched together. This is called sphincter surgery.

Or, you may be implanted with a device to stimulate the nerves responsible for controlling bowel movements. 

A colostomy is a final option. In this surgery, your colon is redirected to your belly region through an opening near the skin. A bag attached to the skin is used to collect the stool.

Prevention of Bowel Incontinence

Certain measures may prevent bowel incontinence:

  • Avoid foods which may cause gas
  • Limit protein and sodium intake
  • Consume food rich in natural fibres
  • Take proper measures to control constipation
  • Control diarrhoea
  • Avoid excess straining during bowel movements

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