ColomboSurgeon

Anal Incontinence

What is anal incontinence?

 

Anal incontinence, also known as fecal incontinence, is the inability to control bowel movements, leading to the accidental leakage of stool (solid or liquid) or gas. It can range from occasional leakage when passing gas to a complete loss of bowel control.

 

What causes anal incontinence?

Anal incontinence can result from various underlying conditions, including:

  • Damage to anal muscles: Often due to childbirth, surgery, or trauma.
  • Nerve damage: Caused by conditions like diabetes, multiple sclerosis, or spinal injuries.
  • Chronic constipation: Can stretch and weaken the rectal muscles over time.
  • Diarrhea: Frequent, loose stools can make it harder to control bowel movements.
  • Rectal prolapse: A condition where the rectum slips out of place.
  • Aging: Reduced muscle strength and nerve function with age.

Symptoms

  • Accidental leakage of stool during daily activities.
  • Inability to control the urge to have a bowel movement.
  • Unawareness of leakage until it has occurred.
  • Frequent or sudden urgency to use the bathroom.
  • Soiling of underwear or skin irritation around the anus.

When to see a Doctor

Contact your doctor if:

  • Symptoms affect your daily activities or emotional well-being.
  • You experience pain, bleeding, or signs of infection.
  • Bowel habits suddenly change or worsen.

 

Diagnosis

To identify the cause of anal incontinence, your doctor may:

  • Take a detailed medical history and perform a physical examination.
  • Recommend tests such as:
    • Anorectal manometry: Measures muscle strength.
    • Endoanal ultrasound: Assesses muscle structure.
    • MRI: Provides detailed imaging of pelvic muscles.
  • Stool tests: To rule out infections or inflammation.

 

 

Treatment

Treatment depends on the cause and severity of the condition. Options include:

  • Lifestyle and Dietary Changes
    • Eat more fiber to regulate bowel movements.
    • Avoid foods that worsen symptoms (e.g., caffeine, spicy foods).
    • Stay hydrated and exercise regularly.
  • Pelvic Floor Exercises (Kegels)
    • Strengthen the anal sphincter and pelvic muscles for better control.
  • Medications
    • Anti-diarrheal drugs: To reduce loose stools.
    • Stool softeners: To ease constipation.
  • Biofeedback Therapy
    • A specialized therapy to improve muscle coordination and control.
  • Surgical Treatments
    • Sphincteroplasty: Repairs damaged sphincter muscles.
    • Sacral nerve stimulation (SNS): Stimulates nerves to improve control.
    • Colostomy (rare): Creates a new pathway for stool in severe cases.