Fecal Incontinence
More than 5.5 million Americans have Fecal Incontinence. It affects people
of all ages—children as well as adults. Fecal Incontinence is more common in
women than in men and more common in older adults than in younger ones. It is
not, however, a normal part of aging.
Loss of bowel control can be devastating. People who have Fecal Incontinence
may feel ashamed, embarrassed, or humiliated. Some don't want to leave the house
out of fear they might have an accident in public. Most try to hide the problem
as long as possible, so they withdraw from friends and family. The social isolation
is unfortunate but may be reduced because treatment can improve bowel control
and make incontinence easier to manage.
Fecal Incontinence can have several causes:
Constipation
Damage to the anal sphincter muscles
Damage to the nerves of the anal sphincter muscles or the rectum
L loss of storage capacity in the rectum
Diarrhea
Pelvic floor dysfunction
Constipation is one of the most common causes of Fecal Incontinence. Constipation
causes large, hard stools to become lodged in the rectum. Watery stool can then
leak out around the hardened stool. Constipation also causes the muscles of
the rectum to stretch, which weakens the muscles so they can't hold stool in
the rectum long enough for a person to reach a bathroom.
Muscle Damage
Fecal Incontinence can be caused by injury to one or both of the ring-like muscles
at the end of the rectum called the anal internal and/or external sphincters.
The sphincters keep stool inside. When damaged, the muscles aren't strong enough
to do their job, and stool can leak out. In women, the damage often happens
when giving birth. The risk of injury is greatest if the doctor uses forceps
to help deliver the baby or does an episiotomy, which is a cut in the vaginal
area to prevent it from tearing during birth. Hemorrhoid surgery can damage
the sphincters as well.
Nerve Damage
Fecal Incontinence can also be caused by damage to the nerves that control the
anal sphincters or to the nerves that sense stool in the rectum. If the nerves
that control the sphincters are injured, the muscle doesn't work properly and
incontinence can occur. If the sensory nerves are damaged, they don't sense
that stool is in the rectum. You then won't feel the need to use the bathroom
until stool has leaked out. Nerve damage can be caused by childbirth, a long-term
habit of straining to pass stool, stroke, and diseases that affect the nerves,
such as diabetes and multiple sclerosis.
Loss of Storage Capacity
Normally, the rectum stretches to hold stool until you can get to a bathroom.
But rectal surgery, radiation treatment, and inflammatory bowel disease can
cause scarring that makes the walls of the rectum stiff and less elastic. The
rectum then can't stretch as much and can't hold stool, and fecal incontinence
results. Inflammatory bowel disease also can make rectal walls very irritated
and thereby unable to contain stool.
Diarrhea
Diarrhea, or loose stool, is more difficult to control than solid stool that
is formed. Even people who don't have Fecal Incontinence can have an accident
when they have diarrhea. |
