Fecal incontinence what to do. Regular bowel movements

In such a situation, you need to urgently consult a doctor.

Fecal incontinence - encopresis disease

The reasons for this problem can be very serious. Being in such conditions is a physical and psychological feeling of discomfort at the same time.

Fecal incontinence, or encopresis in other words, varies in severity.

Doctors divide this problem into three degrees:

• 1st degree - inability to hold gases;
• 2nd degree - incontinence of gases, liquid feces;
• 3rd degree - inability to hold liquid and solid stool.

Doctors distinguish 4 types of involuntary bowel movements:

1. Regular appearance of feces without a corresponding urge.
2. Inability to hold stool when there is urge.
3. Inability to even partially retain stool during coughing, physical activity, or sneezing.
4. Incontinence associated with age-related changes.

What are the causes of the pathological condition

The origin of the reasons why this disease appeared is different. They can be either defects acquired at birth or acquired over time.

1. Anatomical pathologies:
   • problems with the rectum (for example, a condition after surgery for a tumor or hemorrhoids);
   • anal defect.
2. Psychological disorders:
   • panic;
   • neuroses;
   • schizophrenia;
   • psychoses;
   • hysterics.
3. Injuries acquired after childbirth or brain injury.
4. Diarrhea caused by an acute infectious infection.
5. Injuries of the rectum of the obturator apparatus.
6. Neurological abnormalities caused by damage to the pelvis, tumors of the anus, diabetes mellitus.
7. Alcohol addiction.

It should be said that alcoholism is a very common cause of fecal incontinence in men and treatment in this case consists of eliminating alcohol dependence.

Also, the causes of this problem may have a completely different origin.

For example, perhaps due to serious diseases such as:

• manic-depressive syndrome;
• epilepsy;
• psychological instability;
• catonic syndrome;
• dementia.

Sometimes signs of encopresis appear after childbirth. In general, absolutely all damage to the anal apparatus can lead to such a case.

If you find at least some signs of the appearance of this disease, even the slightest, you should immediately seek help from a neurologist or proctologist.

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Onset of the disease in adults

Childbirth, which can provoke damage to the intestines or pelvis, is a common cause of fecal incontinence in women and treatment in this case should be comprehensive.

Also a common cause is loss of control over the process of defecation due to a malfunction of the external sphincter, as well as anal insufficiency. Chronic diseases and pathologies of the nervous system can lead to such consequences.

• in a dream;
• fainting;
• under stress;
• with other uncontrolled processes of loss of consciousness.

For an adult, unlike small children, this causes a lot of inconvenience and the feeling of comfort will immediately disappear.

Encopresis in the older generation

Encopresis is a very common problem among older people. It happens due to improper activity of the cortical center, which is responsible for the process of defecation.

In old people, this problem is not congenital, but appears with the advent of age, which means it is already an acquired disease. Doctors can often witness a receptor inability to retain stool in the absence of the urge to have a bowel movement.

Since the cause may be hidden in a person’s psychological state, treatment is prescribed with medications and, in addition, a consultation with a psychotherapist is prescribed.

Sometimes it happens that the results do not bring positive dynamics for a long time, this is because the disease is already very advanced.

Problems after childbirth

Childbirth leads to serious consequences. Injury can occur both during natural childbirth and during caesarean section.

Often problems with the anal sphincter occur after the use of vacuum extraction of the fetus or as a result of the application of obstetric forceps. Perineotomies also cause an inability to retain stool.

The level of hormones decreases with age, which means that muscle tissue loses its properties and elasticity, as a result of which the sphincter becomes more vulnerable. Excess weight and chronic diseases can also trigger illness during pregnancy and labor.

After six months, many women manage to get their health in order. But there are those for whom this problem does not leave for a very long time.

Basic principles of treatment

1. The very first thing you need to do is try to restore a regular bowel movement routine. A diet high in plant fiber will help here. And in addition you need to take medications like Imodium.
2. It is necessary to start training the sphincter. This will help prevent relapse in the future. Autotraining will help raise the sensitivity of the intestine to the presence of feces in it to the desired level. These methods help in 70 percent of cases.
3. If the above methods do not bring results, then you will have to resort to surgery. In rare cases, the patient may have to have a colostomy. With its help, a direct path is created for the patient between the wall of the abdominal cavity and the colon. But the anus has to be closed and defecation occurs in a specially attached container, which is secured near the abdominal wall.
4. A timely visit to the clinic can save you from a large number of problems. Everything can be fixed in a short time, if, of course, you don’t let everything take its course. Do not be afraid to contact competent specialists who will certainly help you.

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Prevention of fecal incontinence

The development of this disease can be prevented by simply following a few simple rules and following some recommendations:

• It is important to undergo examination and treat diseases related to proctology.
• Sexual contact through the anus should be avoided.
• Do not tolerate defecation if desired.
• It is advisable to train the muscles of the anus. It is enough to squeeze and relax your muscles in an accessible place and at a time that suits you.

There is also a general set of exercises that involves the development of all muscles.

Even at the slightest sign, consult a doctor; do not neglect yours or the health of your loved ones.

Medical treatments for encopresis

Fecal incontinence is medically called encopresis. Very often it occurs against the background of other diseases. Therefore, in order to carry out effective drug treatment, it is necessary to conduct a comprehensive diagnosis and identify all health-related problems. Depending on the underlying causes, medical treatment methods come down to:

• surgical intervention;
• conservative methods.

Surgical intervention has shown satisfactory results for many years. Surgery may be prescribed in a situation where involuntary bowel movements are caused by injury or a sphincter defect. Experts classify this procedure as plastic surgery.

Taking into account the degree of damage to the sphincter and the length of the defective area, operations are divided into types.

1. Sphincteroplasty is an operation that is performed in case of damage to no more than a quarter of the sphincter circumference.
2. Sphincterogluteoplasty is a procedure that is required for large amounts of damage. During the operation, material from the gluteus maximus muscle is used to restore sphincter function.
3. Operation Tirsha. Involves the use of synthetic materials or silver wire. It is practically not used in modern medicine.
4. Fireman's operation. To carry it out, material from the thigh muscle is used. This procedure has a short-term positive effect.
5. In cases where incontinence problems are not associated with mechanical disorders, post-anal reconstruction is performed.

In addition to surgery, medications have proven effective in eliminating the problem of fecal incontinence. They are most often used in cases of functional disruption of the digestive system. This may be diarrhea, frequent loose stools, a combination of incontinence along with constipation.

All drugs are divided into two groups. The first task is to eliminate the signs of the underlying disease. The purpose of the second group is to influence muscle tone in the perineum and sphincter. Strychine tablets, subcutaneous injections of proserine, ATP and group B vitamins have shown high effectiveness. In case of increased muscle excitability, the use of tranquilizers is recommended.

Traditional medicine recipes

When diagnosing encopresis, along with medications, it is recommended to use traditional medicine methods. They are aimed at overall improvement of the patient’s well-being and normalization of the body’s functioning.

For effective treatment, it is necessary to normalize nutrition and try to minimize situations that lead to nervous excitement. Optimally - a peaceful environment, complete calm.

Every day for at least a month you should give an enema from a decoction of chamomile flowers. To carry out the procedure, you need to inject 400 ml of the prepared broth into the rectum. After this, you should walk around with it inside. The procedure time is as long as possible. The broth should be warm. Temperatures range from 22 to 38 degrees. Such enemas are not only therapeutic, but also training in nature.

Another popular method is training on a special tube. It is necessary to take a tube with a diameter of about 1 cm. For a length of 5 cm, it is lubricated with Vaseline and inserted into the anal canal. After this, exercises are performed for the sphincter muscles. The exercises consist of sequential squeezing and unclenching of the muscles. Then you need to walk around the room, trying to first hold the tube and then push it out.

For complex therapy, folk choleretic decoctions are used. They are necessary to normalize the functioning of the gastrointestinal tract. A decoction of calamus roots has proven itself best. It is recommended to consume honey daily. A teaspoon is enough; rowan fruits and its juice also work well.

The active removal of toxins from the body is facilitated by taking a glass of water with the addition of lemon juice on an empty stomach. Green tea and fresh fruit juice have proven themselves to be excellent.

In addition to medications and exercises to strengthen the sphincter muscles, patients are prescribed a diet. The main task is to normalize nutrition for the proper functioning of the digestive system.

First of all, it is necessary to exclude from the diet those foods that can cause diarrhea: caffeine, alcohol. In case of lactose intolerance or poor protein tolerance, all dairy products are removed from the diet. It is not allowed to consume whole milk, cheese, butter, or ice cream. It is also not recommended to eat fried, salty, spicy, smoked foods.

The diet should not contain dietary products. This means avoiding sugar substitutes, sorbitol, xylitol, fructose and other dietary components. It is best to organize food consumption in small portions, but at regular intervals. This can be 5-6 meals a day.

You should add more cereals and dishes to your diet that help thicken your stool. Be sure to daily consume foods containing fiber: fresh vegetables and fruits. It is better to purchase bread from coarse grains. Dietary fiber preparations can be used as a dietary supplement. With their help, the stool will become larger and more manageable. Despite the ban on dairy products, kefir and other fermented milk drinks should be present in the diet. They have a good effect on intestinal microflora and digestion.

What are the prognosis for the development of the disease in patients with encopresis?

Fecal incontinence is a fairly common disease that is caused by a wide variety of reasons. If you contact a specialist in a timely manner, the prognosis for its development is the most optimal.

If you do not pay attention to the disease and let it take its course, then encopresis begins to develop. It is moving into more serious stages.

In total, there are 3 stages of the disease.

1. The first stage is characterized by gas incontinence. This is an unpleasant symptom, but it does not have a direct impact on a person’s life. The patient can perform normal activities and live a full life.
2. At the second stage, incontinence of unformed feces occurs. This situation requires the intervention of a specialist in order to adjust the diet and prescribe medications that will help thicken and shape the stool. It is recommended to perform gymnastics for the sphincter muscles. This stage of the disease is already noticeable to others, since the patient may not have time to get to the restroom in time. As a result, there is a gradual separation of the patient from the team. He avoids long public events.
3. The third stage is characterized by the inability to hold even dense feces. In this situation, functional disorders of the sphincter muscles are possible. If medicinal methods and gymnastics do not help, then surgical intervention is indicated.

Despite the fact that the social standard of living of the patient is seriously affected, encopresis can be cured. Situations where fecal incontinence is caused by hemorrhagic or ischemic stroke are considered unfavorable for the prognosis. But it leads to disruption of not only the process of defecation, but also paralysis, speech impairment and other problems.

What causes fecal incontinence and how to cure it

Fecal incontinence is a medical condition characterized by a disorder in which a person is unable to control bowel movements. Bowel cleansing occurs spontaneously. The patient loses calm and becomes psychologically unbalanced.

Fecal incontinence has a special medical term - encopresis. The disease is usually associated with the development of organic pathology. All factors are significant and require elimination and urgent consultation with a doctor.

Clinical description of the pathology and the principle of the defecation process

Fecal incontinence in adults is an unpleasant and dangerous phenomenon. A person loses the ability to control internal processes; bowel cleansing is not controlled by the brain.

Feces can be of different consistencies - solid and liquid. The emptying process itself does not change. Fecal incontinence in women is diagnosed less frequently than in the stronger half of humanity. Statistics give figures - one and a half times less. But this does not allow women to be calm and confident that they are not afraid of such a pathology. The disease is nearby, waits for favorable conditions and manifests itself, disrupting the usual way of life.

There is an opinion that the pathological disorder is characteristic of old age. Fecal incontinence in the elderly is an optional sign of age; doctors have proven that this opinion is wrong. Statistics provide figures that explain the emergence of such opinions. Half of the patients are people over 45 years of age. Age is only one of the reasons that leads to illness.

To understand why fecal incontinence occurs, you need to understand the process of managing bowel movements. Who controls at what level of physiology this is laid down. Several systems control the output of feces. Their coordination leads to the normal functioning of the body.

1. The rectum contains a large number of nerve endings that are responsible for the functioning of muscle structures. The same cells are located in the anus. The muscles hold the feces and push them out.
2. The rectum is located inside the intestine so as to hold feces and send it in the right direction. Feces, once in the rectum, already acquire their final state. It is dense, compressed into voluminous ribbons. The anus closes its exit without control.
3. The compressed state of bowel movement is maintained until it is released, when the person is ready for the act of defecation and understands that it has occurred. In a normal state, a person can restrain the process until he can go to the toilet. The delay time can be hours.

The sphincter plays an important role in the process. More precisely, the pressure in his area. Normally, it varies from 50 to 120 mmHg. For men, the norm is higher. The anal organ in a healthy state should be in good shape; a decrease in its functionality leads to worsening bowel movements. Its activity is controlled by the autonomic nervous system. It will not be possible to consciously influence the sphincter. Stimulation of fecal output occurs at the level of irritation of receptors in the walls of the rectum.

Scientific explanation for passing stool:

• simultaneous vibration of the peritoneal muscles and closure of the main opening (slit passage);
• increased pressure on the sphincter;
• delayed compression of intestinal segments;

All processes lead to advancement, pushing feces towards the anus. The process is slow and cannot be accelerated. The pelvic muscles enter a relaxed state, the muscles open the rectal outlet. The internal and external sphincter relaxes. When a person cannot get into the sanitary room, he strains the internal receptors, the anorectal opening remains closed and tight. The degree of tissue tension stops the urge to go to the toilet.

Causes of fecal incontinence

There are a number of factors that cause fecal incontinence in adults.

The most common reasons:

• constipation;
• loose stools;
• weakness and damage to muscle mass;
• nervous conditions;
• decreased muscle tone relative to normal;
• dysfunction of the pelvic organs;
• hemorrhoids.

You can consider and analyze the causes of fecal incontinence in detail.

1. Constipation. Solid waste from food processing accumulates in the intestines. The tissue in the rectum stretches, which relieves pressure on the sphincter. When constipated, a person has a desire to soften stool. Liquid stool accumulates above solid feces. They leak out and damage the anal passage.
2. Diarrhea. Diarrhea changes the condition of the stool, this becomes a factor in the development of pathology. Treatment of fecal incontinence becomes the first and necessary action to eliminate symptoms.
3. Innervation problems. Impulses are subject to two types of disturbance. In the first option, the problem is based on nerve receptors, the second - on abnormalities in the functioning of the brain. This is often characteristic of the senile state, when the activity of brain processes decreases.
4. Scars on the walls of the rectum. Due to a decrease in the strength of the walls of the lining of the esophagus, enuresis and encopresis begin to appear. Unpleasant processes disrupt the condition of the adult organ, and scars form. Sometimes scars form after inflammation, surgery, or radiation.
5. Hemorrhoidal venous seals. The knots prevent the hole from closing, the muscles become weak and inactive. In older people, hemorrhoids change the entire bowel movement process.

Treatment methods

It is based on certain principles:

• adjustment of regime and diet;
• medicines;
• training the muscles of the intestinal systems;
• stimulation of work using electrical equipment;
• operational activities.

Each principle will be analyzed by a specialist. Treatment of encopresis is aimed at eliminating the problem - the cause that caused the disruption of the bowel movement.

Medicines

Among medications that help normalize the functioning of the digestive system, Imodium tablets are considered one of the most popular. In medical language they are called Loperamide.

Drug groups:

• antacids;
• laxatives;
• therapeutic.

Other anti-diarrhea drugs intervene in the disease and produce additional healing effects:

1. Atropine, Belladonna. Anticholinergic drugs, they reduce the development of secretion and increase peristalsis. Motility of the intestinal walls returns to normal. Can be used at various stages.
2. Codeine. The drug relieves pain, as it is one of the derivatives of the opium group of drugs. More often it happens that it is included in the group of dangerous contraindications. Prescribed only on the recommendations of a doctor.
3. Lomotil. A medicine with this name reduces the movement of feces and creates conditions for its hardening.

The most common are activated carbon tablets. The substance is named after the active element of its composition. Coal absorbs liquid and expands feces in volume. In addition, the medicine removes toxic substances from the body.

Home treatments

The problem may arise when it is impossible to go to a medical facility. Then you have to turn to the advice of healers, healers from the people. At home, the disease has been eliminated for many centuries. Treatment of fecal incontinence was carried out in villages, where grandmothers selected medicinal herbs and created miraculous tinctures.

You can use folk remedies, but such an action should not be permanent. What reasons led to loose stools, what caused intestinal malfunctions? Answers to questions can be obtained after a full examination and diagnostic procedure.

1. Enemas. Chamomile decoctions are used to carry them out. Take 50 g of medicinal herb and place it in a liter of boiling water. Over low heat, wait for the chamomile components to completely dissolve. Then cool to room temperature and insert into the rectum. You need to hold the medicine inside for a very long time, you can help with the help of medical devices or hands.
2. Infusions for internal use. The base is calamus grass. It is steamed in boiling water, the proportions are 20 g of herb, 200 ml of liquid. You can’t make a lot of water compositions. A liter of healing infusion is sufficient for a course of 7 days. Drink 1 spoon after meals.
3. Rowan juice. The fruits of the tree help when eaten fresh and pressed into a drink. Dosage rate: one spoon no more than 3 times a day.
4. Honey products. Honey, 1 tablespoon per day, will be both a therapeutic and preventive method of eliminating the disease.

Pathology after childbirth

Changes in bowel movements occur during pregnancy. Women hope that everything will end after childbirth. More often, the disease continues to occur and intensify. The problem becomes not so much physiological as psychological.

Fecal incontinence after childbirth is due to the following reasons:

• impaired innervation of the bladder muscles;
• deviations in the functioning of the muscles of the pelvic organs;
• pathologies of the urethra;
• dysfunction of the bladder and urinary systems;
• instability of pressure inside the bladder.

The pathology occurs along with another process - gas incontinence is observed. A large number of women consult doctors after childbirth with such symptoms. They are trying to understand the reasons why gas incontinence occurs after childbirth.

There is not just one reason for the phenomenon, it is a whole complex:

1. Trauma to the anus during labor.
2. The birth of a large fetus against the background of external and internal ruptures.

There are also medical pathologies that, with fecal incontinence, often become noticeable after childbirth.

Treatment methods for female diseases

Your doctor will tell you what to do to eliminate unpleasant symptoms.

The methods were developed by specialists based on the experience of doctors in studying the causes of fecal incontinence.

1. Operations to introduce a special gel into the canal. This type of therapy is used to strengthen the walls of the anus. The method does not promise a complete cure; relapse may occur.
2. Fixation of internal organs. Operations are rarely used. Surgeons secure the fluid emission channel, cervix, and bladder. After the intervention, a long recovery period will be required.
3. Loop method. One of the most frequently performed methods of surgical intervention. To eliminate urinary and fecal incontinence, a support is created from a loop of special medical material.

Treatment after injury to the sphincter region or damage to the pelvic muscle tissue consists of the method of modern technologies - sphincteroplasty. The surgeon stitches torn, stretched muscles. Another way is an artificial organ, which can be controlled by the person himself. The surgical cuff is inflated and deflated. Fecal incontinence after surgery can be hidden by simple measures: clean, changeable clothes, taking medications that reduce the smell of stool accompanied by gases.

Fecal incontinence in the older generation

Treatment for encopresis depends on the age of the patient. Fecal incontinence in the elderly is a common problem.

Almost every person knows what diarrhea is. Under certain conditions, a single deterioration becomes a frequent illness. Knowing the causes and factors of its development will help you avoid pathology and maintain your usual lifestyle.

Encopresis is a big problem, but folk remedies can solve it

A rather unpleasant pathology characterized by fecal incontinence or a temporary or congenital inability to control the act of defecation is called encopresis. Absolutely anyone can experience this disease, regardless of gender and age. Treatment of the disease must be immediate and appropriate. Treatment of encopresis with folk remedies is acceptable and possible, but only as an additional treatment.

According to statistics, the pathology is more common in children, mainly boys aged 5 years. In adults, the disease is rarely diagnosed. Women who have had a difficult birth are more susceptible to developing the disease.

In addition, the problem becomes especially relevant with age. The disease develops due to degenerative changes caused by natural aging. Encopresis in older people is diagnosed one and a half times more often than in adults under 50 years of age.

What provokes the development of the disease and how to deal with it?

Fecal incontinence in adults can develop due to developmental defects, as well as rectal defects. These reasons are congenital. There are many more acquired reasons. So, pathology can develop as a result of:

• poor nutrition;
• muscle hypotension;
• postoperative or postpartum injuries;
• metabolic disorders;
• mental disorders: psychosis, schizophrenia, hysteria;
• rectal fistulas;
• diabetes mellitus;
• rectal rupture;
• domestic or surgical trauma to the pelvic organs;
• anal tumors;
• brain damage.

The disease is unpleasant and brings a lot of discomfort into a person’s life. Treatment of the disease must be timely. Only a doctor can prescribe the use of a particular drug. Along with traditional therapy, it is recommended:

• Healthy food;
• train the pelvic floor muscles;
• have bowel movements regularly;
• use preparations from medicinal plants.

Patients are prescribed a diet. It is recommended to include in the diet: soybeans, lentils, peas, beans, bran, fruits (apples, peaches and pears are not allowed), brown rice, nuts, whole wheat pasta, potatoes, pumpkin, dried fruits, flaxseed, oatmeal.

Avoid eating dairy products, drinks, sweets, caffeine-containing products, spicy and fatty foods, sausages, ham, sausages, and alcoholic beverages. People suffering from the disease need to follow a drinking regime. During the day, it is recommended to drink two liters of purified still water.

Alternative medicine in the fight against fecal incontinence

The use of a particular drug must be approved by the attending physician. Do not self-medicate under any circumstances, this can harm you and cause the situation to worsen.

1. Use of enemas. It is recommended to do cleansing enemas for a month. For this purpose, it is recommended to use chamomile decoction. The same folk remedy can be used for training enemas. Brew 50 grams of plant flowers in a liter of boiled water. Boil the mixture over low heat for a quarter of an hour. Cool and use for colon cleansing. As for training enemas, here you need to use about 300 ml of a decoction of 30 - 40 degrees. Inject the mixture into the rectum and try to hold it in for as long as possible.

2. Calamus infusion will help in the fight against the disease. Steam 20 grams of dried finely chopped plant roots with 200 ml boiling water. Place the product in a warm place for an hour, or better yet, leave it in a thermos. Take a spoonful of the product after each meal.

3. Rowan against encopresis. Both fresh fruits of the plant and freshly squeezed juice can be used for treatment. Take a spoonful of berries or juice three times a day, after meals.

4. Honey is an ideal natural medicine. Consume 10 grams of honey three times a day.

Treatment of encopresis in children

Encopresis in children is a fairly common occurrence. Doctors recognize the pathology, first of all, as psycho-emotional, but they also do not exclude congenital pathologies. The occurrence of the disease may be due to:

• traumatic brain injuries;
• pathologies of fetal development;
• complications during childbirth;
• congenital anomalies of the lower intestine;
• general neurotic disorders;
• emotionally unstable situation in the family;
• psychosomatic disorders;
• acute inflammatory processes in the gastrointestinal tract;
• improper functioning of the nerve receptors of the anus.

Unfortunately, not all parents are able to immediately identify the pathology. The child will hide the problem in any case, even if he is only four years old. Therefore, mom and dad need to be as attentive as possible to their child. If a problem is detected, the first thing to do is contact your pediatrician. The sooner therapy begins, the sooner your baby will get rid of the disease.

Treatment of encopresis in children should be comprehensive. Along with the therapy prescribed by a specialist, it is recommended to use informal medicine. They will contribute to the speedy elimination of the disease.

Since encopresis is often accompanied by constipation, in order to prevent the accumulation of feces in the intestines, you need to adhere to a diet. It is recommended to include vegetable soups, cabbage dishes, fermented milk products, herbs, honey, and dried fruits in the baby’s diet.

Also, in order to prevent constipation, you should give your baby 10 ml of vegetable oil before each meal. Sunflower or olive oil will do.

Using enemas

In the treatment of encopresis using traditional medicine, enemas are of great importance. It is better to conduct them in the morning. Cleansing procedures promote the development of the voiding reflex, and, importantly, do not leave feces for involuntary excretion. Enema volume ml. The course of therapy is twenty procedures.

In order to reduce nervous tension, it is recommended to take medicinal baths. To do this, you can use infusions of the following herbs: valerian, chamomile, calendula, sage, lavender, string, motherwort, mint, calamus. An excellent effect can be achieved using fees.

Mix calamus rhizome with sunflower seeds and valerian roots in equal proportions. Brew 100 grams of raw material in a liter of boiling water. After an hour, filter and add to the bath. The duration of the procedure is a quarter of an hour. It's better to spend it in the evening.

Combine equal amounts of lavender with mint, lemon balm, rosemary, thyme, thyme, sage, fume and mallow. Steam 150 grams of the mixture in a liter of boiled water. Let the composition brew. After straining, pour into the bath. The duration of the procedure is 20 minutes.

Folk remedies for treating the disease are effective and efficient. However, you must understand that the therapy process itself is labor-intensive and lengthy. The right approach, following all the doctor’s instructions and proper nutrition - all this contributes to a speedy recovery.

Fecal incontinence - causes, diagnosis, treatment

What is fecal incontinence

The mechanism of development and causes of fecal incontinence

1. Psychogenic fecal incontinence, which can be caused by neurotic and hysterical psychoses, pathocharacterological personality disorders, and dementia.

2. Against the background of mental illness (dementia, schizophrenia, epilepsy).

Group 1 – against the background of diseases related to the digestive tract and excretory system (rectal prolapse, anal injuries, accumulation of large amounts of hard feces in the rectum).

Practical classification of fecal incontinence

In practice, fecal incontinence is usually divided according to severity:

I degree – manifests itself in gas incontinence.

II degree – characterized by incontinence of unformed feces.

III degree – is expressed in the patient’s inability to retain dense stool.

Epidemiology and statistics of fecal incontinence

Diagnosis of fecal incontinence

• Endorectal ultrasonography. Thanks to this method, it is possible to evaluate the thickness of the anal sphincters (external and internal). In addition, the method allows you to detect the presence of defects that cannot be detected by manual examination.
• Manometry of the anal canal. This method involves determining the resting pressure and tension created in the anal canal. Using anal canal manometry, you can assess the tone of the anal sphincters.
• Determination of volume-threshold sensitivity of the rectum. If there is a deviation from the norm (a decrease or increase in this indicator), the patient’s act of defecation is disrupted, and this, in turn, leads to the absence of the urge to defecate or, on the contrary, causes an urge that requires immediate bowel movement.

Treatment of fecal incontinence

1. Operation Tirsha- using synthetic materials or silver wire (nowadays it has practically been abandoned).

2. Operation Fireman– using the thigh muscle as a plastic material (its effectiveness, unfortunately, is short-lived).

• Complex exercises aimed at training the anal sphincter(were developed by scientists Dukhanov and Kegel). The essence of these exercises boils down to the fact that a rubber tube, pre-lubricated with Vaseline, is inserted through the anus into the rectum. The patient contracts and relaxes the anal sphincter on command. Exercises are performed daily for 5 sessions. The duration of 1 session is 1-15 minutes. The treatment cycle lasts 3-8 weeks. In parallel with these exercises, it is recommended to perform physical exercises aimed at strengthening the muscles of the gluteal region, abdominal muscles and adductor muscles of the thigh.
• Electrical stimulation– carried out with the aim of stimulating the nerve endings responsible for the formation of a conditioned reflex to defecation.
• Biofeedback. This technique has been practiced in the world for more than 30 years, but has not yet become popular in Russia. Foreign colleagues note that this method, compared to others, gives not only the most positive results, but also the most lasting.

I would like to pay special attention to this technique. It is carried out using biofeedback medical devices. The principle of operation of the biofeedback apparatus is that the patient is given the task of contracting and being able to hold the tension of the external sphincter in a given mode. An electromyogram is recorded using a rectal sensor, and the information is displayed on a computer in the form of graphs. The patient, upon receiving information about how correctly the task is being performed, can consciously control and adjust the duration and strength of contraction of the sphincter muscles. This, in turn, significantly increases the effectiveness of external sphincter training and helps restore the corticovisceral pathways, which are responsible for the function of retaining intestinal contents. Using this method, it is possible to achieve positive results in 57% of cases.

Prognosis for fecal incontinence

Fecal incontinence as a symptom of other diseases

In this article, we will not consider in detail the immediate causes, course and treatment of stroke. Let us draw your attention only to what symptoms accompany these pathologies.

As a result of a stroke, the patient develops a whole complex of disorders, which is associated with a disruption of the blood supply to a certain area of ​​the brain. Depending on the affected area, certain symptoms are expressed to a greater or lesser extent.

• movement disorders or paralysis (impaired coordination of movement, difficulty walking, complete impairment of movement on one or both halves of the body);
• swallowing disorder;
• speech impairment (mainly with damage to the left hemisphere of the brain);
• disturbance of perception (there is no adequate perception of the surrounding reality);
• cognitive impairment (the ability to perceive and process information decreases, logic is impaired, memory decreases, the ability to learn is lost);
• behavioral disorders (slow reactions, emotional instability, fearfulness, disorganization);
• psychological disorders (sharp mood swings, unreasonable crying or laughing, irritability, depression);
• disorders of urination and defecation (no control over physiological functions, impaired tone of the anal sphincter).

2. Disorders of the pelvic organs

This name refers to a complex of disorders of the pelvic organs. There are many reasons for the development of this condition. Let's highlight the main ones: brain tumors, encephalitis, atherosclerosis, multiple sclerosis, mental disorders, epilepsy, Alzheimer's disease, malformations of the genitourinary organs, weakness of the pelvic floor muscles, rectal prolapse, uterine prolapse, enuresis, prostatitis, damage to the urinary tract and excretory system of the intestines with surgical interventions and injuries.

• constipation;
• acute urinary retention;
• urinary incontinence;
• incomplete emptying of the bladder;
• pain during bowel movements and urination;
• false urge to urinate and defecate;
• fecal incontinence;
• impotence.

3. Spinal cord disorders

This group of disorders occurs when the spinal parts of the nervous system located in the spine are damaged. The causes of this group of disorders may be: meningitis, sigingomyelia, spinal cord malformations, multiple sclerosis, amyotrophic sclerosis, spinal cord tuberculosis, spinal cord tumors, spinal cord injuries.

• disturbance of movement in the extremities (upper, lower);
• decreased or complete absence of sensitivity (tactile, temperature, pain; can be observed on one or both halves of the body, above or below the level of spinal cord damage);
• fecal and urinary incontinence.

4. Injuries, including birth injuries

This group of diseases is associated with traumatic exposure, which affects the anal sphincter and, as a result, fecal incontinence occurs. In the case of severe injuries, this group of diseases is characterized by a complex of symptoms that depends on the size of the injury and the depth of the lesion. With birth injuries, pathology develops during difficult births, most often not in medical institutions. In both cases, patients are subject to surgical treatment followed by rehabilitation, which is selected individually.

Fecal incontinence

Fecal incontinence

What is fecal incontinence?

Who suffers from fecal incontinence?

• diarrhea;
• disease or injury affecting the nervous system;
• general poor health caused by several chronic or long-term illnesses;
• difficult childbirth with injuries to the pelvic floor muscles, muscles, ligaments and tissues supporting the uterus, vagina, bladder, rectum.

How does the intestine control bowel movements?

What are the causes of fecal incontinence?

• diarrhea
• constipation
• muscle damage or muscle weakness
• nerve failure
• decreased tone of the rectal muscles
• haemorrhoids
• pelvic floor dysfunction

Diarrhea. Diarrhea can lead to fecal incontinence. Loose stool fills the rectum faster and is more difficult to hold down than hard stool. Diarrhea increases your chances of not getting to the toilet on time.

What tests are performed for fecal incontinence?

• When did fecal incontinence start?
• How often do episodes of fecal incontinence occur?
• How much stool is leaked? Is it a chair or just soiled underwear? Is only a small amount of solid or liquid stool leaking? Or is there a complete loss of control over bowel movements?
• Is there a strong urge to defecate or does it occur without urge?
• If there are hemorrhoids, do the hemorrhoids come out through the anus?
• How does fecal incontinence affect everyday life?
• Do some foods seem to contribute more to fecal incontinence?
• Is the patient able to control flatulence (passing gas)?

Based on the answers to these questions, the attending physician may refer the patient to a specialist: gastroenterologist, proctologist, or colorectal surgeon. The specialist will examine you and may suggest one or more of the following diagnostic tests, which can be done in a hospital or clinic:

• Anorectal manometry uses a pressure-sensitive tube to test the sensitivity and function of the rectum. Anorectal manometry also tests the ability of the anal sphincter muscles to provide the necessary compressive force and the ability to respond to nerve signals.

  On the radiograph (V.D. Pasechnikov): defecography of normal defecation (left) and obstructive defecation (right).

  • Sigmoidoscopy, in which a flexible tube with an illuminator is inserted through the anus into the rectum and, further, into other lower parts of the colon, through which the intestine is examined from the inside in order to detect possible causes of fecal incontinence such as inflammation, tumors, scars.

  How is fecal incontinence treated?

  • nutrition, diet, diet
  • medicines
  • exercises for the pelvic floor muscles
  • bowel training
  • surgery
  • electrical stimulation.

  Nutrition, diet, diet

  • Eat the right amount of protein. In many patients cellulose(other name vegetable dietary fiber) increases the volume of the stool, making it softer and better manageable. Fiber can help with diarrhea and constipation. Fiber is found in fruits, vegetables, whole grains and beans. Fiber supplements are available in pharmacies and health food stores. Fiber foods are another universal way to treat fecal incontinence. A normal diet should include 20 to 30 grams of fiber per day. Fiber should be added gradually to avoid flatulence.
  • Drink plenty. Eight 250-gram glasses of fluid a day can help prevent constipation. Water is a good choice. Drinks containing caffeine, alcohol, milk, or carbon dioxide should be avoided if they cause diarrhea.

  Prolonged diarrhea can become an obstacle to the human body receiving sufficient amounts of vitamins and minerals. A doctor may recommend vitamin supplements to help treat this problem and provide information about what changes in food, diet, or nutrition may improve the patient's condition.

  • dairy products such as milk, cheese and ice cream
  • drinks and products containing caffeine
  • smoked and processed meats such as sausages, hams, turkeys
  • spicy food
  • alcoholic drinks
  • fruits such as apples, peaches and pears
  • fats and fatty foods
  • sweeteners, including sorbitol, xylitol, mannitol, fructose, used in diet drinks and sugar-free chewing gum and candy.

  Fecal incontinence in adults and children: causes, diagnostic methods and treatment methods, recommendations

  Fecal incontinence is one of the serious problems. Characterized by spontaneous excretion of feces. It can occur in both adults and children.

  For what reasons does this phenomenon occur and can the disease be cured?

  Description of the pathological process

  Fecal incontinence or encopresis in adults is a pathological phenomenon that occurs as a result of loss of control over the excretory process.

  The disease is so called when there is a problem with emptying the intestinal tract, a person loses the ability to retain feces inside himself. Because of this, not only the liquid mass leaks, but also the solid mass.

  In 70 percent of all cases, this process is a symptom of various disorders in children over the age of five. Often before this, the child experiences chronic stool retention.

  Most often the disease is diagnosed in men.

  There is also an opinion that fecal incontinence in adults is a sign of impending old age. Many people believe that this disease is only a disease of old age. But the situation looks a little different.

  About 50 percent of patients are between 40 and 60 years of age. But the disease also has a direct relation to old age.

  Causes

  Many patients are interested in the question of why fecal incontinence occurs in adults and children? What reasons may contribute to the development of such a phenomenon? This pathology is always secondary.

  The causes of fecal incontinence in older people, adults and children may be hidden in:

  • constant diarrhea. Diarrhea is considered the most harmless cause of this disease. Due to the fact that the stool becomes liquefied, it is very difficult to keep it in the rectum. Diarrhea acts as a temporary factor for encopresis. After the symptom is eliminated, everything returns to normal;
  • long-term constipation. As a result of the accumulation of solid masses, the intestinal walls begin to stretch and the sphincter begins to relax. Because of this, the urge to empty the digestive canal weakens;
  • injury to muscle structures or weakening of their tone. Damage to the muscles in the sphincter occurs due to household injuries or surgery. The most common occurrence of fecal incontinence is after hemorrhoid surgery;
  • difficulties with innervation. There are two types of disturbances in the conduction of impulses. The first option lies in the nerve endings of the two sections of the sphincter, when the processes of relaxation and contraction are disrupted. Another type is based on problems in the cerebral cortex or the pathway to it. Then the person does not feel the urge to defecate, thereby missing it;
  • scarring of the rectum. This condition is accompanied by a decrease in the elasticity of the intestinal walls. As a result, encopresis occurs. The cause of the phenomenon is inflammation, intestinal surgery, radiation exposure;
  • expansion of hemorrhoids. Swollen cones do not allow the muscular system in the anal passage to fully close;
  • problems with the muscle structures in the pelvis. This may include fecal incontinence after childbirth, when muscle structures have reduced strength. The likelihood of pathology occurring increases in those who have had a rupture or incision in the perineum during childbirth.

  Fecal incontinence in the elderly involves weakening of muscle fibers and loss of elasticity. Some patients experience fecal incontinence after a stroke.

  Unlike senile uncontrolled excretion of feces in children, everything happens for other reasons. First of all, it should be noted that in children up to the age of 4-5 years, this process is quite normal. It is often accompanied by enuresis and is physiological in nature. Gradually, with age, the child acquires skills and is able to hold feces or urine.

  This phenomenon also occurs in children for psychological reasons. Often, children cannot go to the toilet outside the home, as it causes them discomfort. If you do not go to the toilet for a long time, the process can occur spontaneously.

  It is worth mentioning separately about children from disadvantaged families. Faecal incontinence can occur in the absence of the required skills. Parents do not monitor the child. This phenomenon may be accompanied by a constant disorder, as a result of which they do not recognize the smell of feces and do not react in any way to the discharge.

  Diagnosis

  If you are unable to hold your stool, it is not that difficult to diagnose. If a patient experiences fecal incontinence, the causes should be recognized as soon as possible and then treated with therapy.

  Based on the person’s complaints, the doctor prescribes an examination, which includes:

  • anorectal manometry. This technique is performed to identify the level of susceptibility of the rectum. The force of compression of the sphincter and its innervation is also assessed;
  • magnetic resonance imaging. This method helps to take high-precision photographs of the muscular apparatus of the anorectal area;
  • transrectal ultrasound diagnosis. Performed to evaluate the external structure of muscle strictures;
  • proctography. This technique refers to x-ray examination. It allows you to examine the rectum when there is feces there;
  • sigmoidoscopy. The examination consists of visually examining the intestinal walls for the presence of scars and tumors;
  • electromyography. This method makes it possible to assess the condition of the neuromuscular system in the pelvic floor.

  After identifying the cause, the attending physician prescribes treatment for encopresis based on the patient’s age and characteristics of the disease.

  Therapeutic measures

  How to treat encopresis at home? Treatment of encopresis is carried out based on the cause of the disease.

  Diet

  This technique for fecal incontinence is used only when the cause is constipation or diarrhea.

  1. It is necessary to consume foods that contain high fiber content. Their effect is aimed at normalizing the consistency and manageability of stool, preventing the formation of constipation. But their content in the diet must be increased gradually, since a large accumulation of gases in the intestines is possible.
  2. Drink plenty of fluids. Precisely purified water, not juices and tea. At the same time, you should take fruit and vegetable juices with extreme caution, as this can lead to diarrhea.
  3. A special diary should be kept indicating what the patient ate. With the development of pathology, he will be able to understand which product leads to a change in the consistency of stool, and exclude it from the diet.
  4. Fecal incontinence in adults over 60 years of age is treated with a folk remedy. To do this you need to use Vaseline oil. It should be taken two spoons up to two times a day. This process helps soften stool and promotes its elimination.

  The doctor decides with the patient on an individual basis what diet to follow.

  Conservative treatment

  What to do if fecal incontinence occurs in women and men? In some cases, the use of medications is required.

  Treatment for fecal incontinence involves:

  • using laxative tablets for constipation;
  • the use of antidiarrheals for diarrhea;
  • the use of medications that reduce the amount of water in stool.

  Along with drug therapy, the patient needs to adhere to some recommendations:

  • compliance with the regime. If the patient has constipation, then it is necessary to establish the process of emptying. We must mentally ask the body to cleanse the body of feces at a certain time;
  • performing physical exercises. They will help strengthen the muscular structures of the pelvic floor and sphincter. This technique will help when gas incontinence occurs after childbirth. An excellent exercise is to relax and contract the sphincter. It is enough to carry out this procedure up to three times a day for a month, and the problem will disappear by itself;
  • conducting physiotherapy. Electrical stimulation has an excellent effect;
  • performing water procedures. You need to take baths or visit the pool more often. This will strengthen the muscle structures.

  Surgery

  If other methods do not help eliminate the problem, the doctor resorts to surgery.

  There are several methods of surgery called:

  • straight sphincter. It is based on strengthening the muscle tissue of the anus with the help of a strong connection with the rectum. It is used in cases where muscles are affected due to damage or atrophy;
  • artificial sphincter. It is placed around the real sphincter. The device is a special cuff that regulates pressure and acts as a pump;
  • colostomy Most often used after surgery on the digestive canal. This procedure involves connecting the large intestine to the anterior abdominal wall. When the process of defecation occurs, the stool will be collected in a bag.

  What type of treatment to choose is up to the doctor to decide based on age, cause of the disease and course.

  Fecal incontinence is medically called encopresis. In some cases, this process is physiological and goes away over time. In other situations, why pathology occurs can only be explained by a doctor on an individual basis.

  But no matter what becomes the decisive factor, you need to follow some tips:

  1. When leaving home, be sure to visit the toilet. It is necessary to empty the intestinal canal by any means.
  2. If the patient is going somewhere far away, then you need to take care of a change of underwear. If necessary, take wet wipes. They will help eliminate the remains of feces.
  3. Take tablets that help reduce the intensity of gas and stool odors. They can be purchased at a pharmacy without a doctor's prescription.
  4. Carry out the treatment prescribed by the doctor.

  Fecal incontinence can lead not only to health problems, but also to social problems. When the first signs of uncontrollable fecal output occur, you should seek help from a specialist and determine the cause of the disease.

A disease of the digestive system in which spontaneous excretion of feces occurs is called fecal incontinence in women; the causes and treatment of this pathology will be described below. Encopresis, which most often occurs in children, develops in adults as a result of any. Fecal incontinence refers to the loss of the ability to control bowel movements. The disease also includes cases of spontaneous leakage of rectal contents, which occurs, for example, when gases escape. In women, this pathology occurs somewhat less frequently than in men. There is an opinion that such a disease is a companion to old age, but this is not so. At the moment, no reliable evidence has been found that all older people, without exception, cannot control the act of defecation.

More than half of patients with this diagnosis are adults (40-60 years old). Age-related changes can also lead to its development. It is fecal incontinence, along with dementia, that causes social isolation in older people. Regardless of the patient’s age, this problem significantly worsens the quality of life, leading not only to the desire to isolate oneself from society, but also to the development of depressive disorders.

1 How does the process of defecation occur?

Before describing the reasons leading to the development of the disease, it is necessary to understand the mechanism of the act of defecation. This process is controlled through the synchronous work of muscles and nerve endings located in the rectum and anus. Retention of feces is ensured by the sphincter muscles, which in a healthy person are tense. When moving to this part of the intestine, feces have a high density. The compressed muscle tissue of the sphincter forms a tight ring that prevents the spontaneous release of feces.

The pressure in the sphincter area is about 100 mm Hg, it decreases with age, but this is not the main cause of encopresis. The sphincter muscles are constantly in good shape; electrical activity is not observed during the act of defecation. Control over the opening of the sphincter while going to the toilet is carried out by the autonomic nervous system. The urge to defecate is a consequence of mechanical irritation of the intestinal walls, which occurs when feces accumulate in the rectal ampulla.

In response to this influence, the person takes the appropriate posture. When the abdominal muscles contract and the glottis closes, intra-abdominal pressure increases. This is facilitated by slowing down the contractions of the rectum, due to which stool moves towards the anus. The pelvic floor muscles relax, opening the anorectal angle. Irritation of the walls of the rectal ampulla leads to the opening of the internal and external sphincters, due to which feces are removed from the body.

If it is impossible to perform an act of defecation, the external sphincter contracts voluntarily, which causes closure of the anorectal angle, and the excretion of feces from the rectum is blocked.

2 Why does fecal incontinence happen?

Fecal incontinence in adults can be caused by the following reasons: diarrhea, muscle weakness, incompetence of nerve endings, decreased elasticity of the walls of the rectum, hemorrhoids. Constipation is a condition characterized by rare bowel movements (no more than 3 times a week). The result of this is encopresis. In some cases, constipation leads to the accumulation of fecal stones in the intestines; if at the same time more are found in the intestines, they can leak out. Long-term constipation leads to stretching of the sphincter and its weakening, which causes loss of control over the excretion of feces.

Diarrhea can also lead to this disease. Liquid stool fills the rectal cavity faster and can be difficult to retain. When the tone of the sphincter muscles decreases, encopresis can also develop. Injuries and surgical interventions contribute to muscle weakening. If signals from the nerve endings responsible for the functioning of the sphincter muscles are incorrectly sent, the order of their compression and relaxation is disrupted. In addition, the nerves may not respond to the filling of the rectum with feces, as a result of which the person ceases to feel the urge to defecate. The main reasons for disruption of the correct functioning of nerve endings are strokes, diseases of the central nervous system, the habit of delaying bowel movements for a long time, and childbirth.

The rectum of a healthy person is capable of spontaneous expansion when it is necessary to retain feces. Certain causes can lead to scarring on the intestinal walls, making them less elastic. Such factors include surgical interventions in the rectal area, ulcerative colitis, radiation, etc. Fecal incontinence in adults also develops due to improper functioning of the muscles and nerve roots of the pelvic floor. The following reasons lead to this:

• decreased sensitivity of the rectal walls to the irritating effects of feces;
• weakness of the muscles that control the flow of bowel movements;
• rectocele, in which the rectum prolapses into the vagina;
• frequent childbirth;
• rectal prolapse due to hemorrhoids.

The risk of developing encopresis in a woman increases significantly when using obstetric forceps during childbirth. No less dangerous in this regard is episiotomy - dissection of the perineum as the child passes through the birth canal. Fecal incontinence can appear either immediately after childbirth or several years later.

External hemorrhoids can be caused by incomplete closure of the sphincter muscles, as a result of which some liquid stool or mucus begins to come out.

Depending on the age of the patient, fecal incontinence may differ in the mechanism of occurrence and type of disorder. Encopresis can manifest itself in the form of frequent stool without a previous urge to defecate. Spontaneous release of rectal contents may be accompanied by an urge to go to the toilet. Irregular leakage of intestinal contents also occurs during exercise, coughing, and sneezing. Encopresis can develop against the background of age-related changes in the body.

3 Methods for diagnosing the disease

When making a diagnosis, the doctor studies the patient’s medical history, takes into account the data of the initial examination and the results of diagnostic procedures. When identifying encopresis, instrumental techniques are mainly used. A pressure-sensitive tube is used to measure anorectal pressure. Its use allows you to determine the nature of the functioning of the rectum. This method is also used to determine the force of compression of the anal sphincter muscles.

MRI allows you to obtain detailed images of the parts of the intestine being studied - the muscles of the external and internal sphincter. Proctography is an x-ray examination that determines the maximum amount of feces that the rectum can hold. In addition, the procedure allows you to study the distribution of contents in the intestinal cavity and determine the efficiency of emptying. Transrectal ultrasound is performed by inserting a special sensor into the anus. The procedure is absolutely painless and safe; it is used to examine the functioning of the pelvic floor muscles and anal sphincters.

Sigmoidoscopy is a procedure that involves inserting a special tube into the anus, through which the rectum is examined from the inside. This allows us to identify the presence of scars, tumors and inflammatory processes.

4 Treatments

This or that treatment for this disease is selected depending on the cause that led to its occurrence. In order to eliminate the patient's symptoms, drug or surgical treatment is performed. In addition, you need to review your diet and constantly train your pelvic floor muscles using special exercises. The operation is performed when conservative treatment does not produce results, as well as in cases where encopresis is caused by injuries to the sphincter or pelvic floor muscles.

This treatment consists of sphincteroplasty - stitching together muscles that have been torn or stretched. There is another method of surgical intervention - installing an artificial sphincter under the skin in the anal area. The patient himself controls the operation of this device by deflating and inflating the cuff.

Fecal incontinence (anal incontinence) is a dysfunction of the rectum and anal sphincters, in which uncontrolled bowel movements occur. For very young children, involuntary bowel movements are considered normal, but if fecal incontinence is observed in adults, this indicates the presence of serious diseases, the symptom of which is incontinence. It is very important to identify the cause of the lesion in time and begin treatment in a timely manner.

Types of disease

Experts, depending on the degree of ability to control the process of defecation, divide anal incontinence into three stages:

• Inability to control the process of gas evolution;
• Incontinence of liquid feces and gases;
• Inability to retain gases, solid and liquid feces.

Moreover, depending on the etiology of the disease, in some cases a person may feel the urge to defecate and the process of leaking feces, but is not able to control them. Another form is characterized by the fact that the patient does not feel either the urge to defecate or the leakage itself - this form of fecal incontinence in old people is most often observed as a result of degenerative processes in the body.

Causes of fecal incontinence

The main causes of the disease can be divided into the following groups:

• Congenital. Spina bifida, rectal defects, malformations of the anal apparatus;
• Organic. Birth injuries, damage to the brain and spinal cord, injuries during proctological operations;
• Psychogenic. Neuroses, psychoses, hysteria, uncontrollable panic attacks.

The causes of fecal incontinence can also be: ischemic colitis, rectal prolapse and cancer, extensive inflammatory processes, diabetes, consequences of pelvic injuries, dementia, epilepsy. Involuntary, one-time fecal incontinence in adults can be triggered by severe stress, food poisoning, or long-term use of laxatives.

Fecal incontinence in children

Until the age of 4, fecal incontinence in children (encopresis) should not cause concern to parents; it is not an anomaly and does not require any treatment. After reaching 4 years of age, encopresis is diagnosed in approximately 3% of children. The main cause of fecal incontinence in children is chronic constipation, followed by unconscious and uncontrolled excretion of feces with significant accumulation in the intestines. Digestive dysfunction can be caused by an unbalanced diet - an excess of meat and dairy products, with insufficient amounts of plant fiber in the diet, as well as low fluid intake. Unintentional bowel movements usually occur during the day while awake, and babies often experience pain in the abdomen and navel area. Treatment of the disease includes a diet that improves intestinal motility and means to eliminate pain during bowel movements.

Problems with the formation of the nervous system can also cause fecal incontinence in children: hyperactivity, inability to maintain attention for a long time, poor coordination. Encopresis can also be caused by psychological factors, such as a feeling of fear, resistance and reluctance to comply with the demands of elders. In this case, the basis of treatment is psychological support from parents and, if necessary, consultation with a psychologist. In the prevention of the disease, timely consolidation of the habit of using a potty is of particular importance, and it is important that planting is not accompanied by unpleasant sensations.

Fecal incontinence in the elderly

Fecal incontinence in adults, especially the elderly, is associated with decreased tone of the anal muscles. If minor defecation disorders may be observed in adulthood, then over time, without adequate treatment, this disease can develop into anal incontinence. In most cases, involuntary bowel movements in older people are a consequence of damage to the rectum. The disease may also be associated with the development of dementia (senile dementia), in which older people do not control their actions and bowel movements.

Treatment of the disease at this age is complicated by many factors, including the advanced stage of the disease. Since incontinence is often caused by a general psychological state, not only drug and surgical treatment is necessary, but also consultation with a psychotherapist. The success of treating fecal incontinence in an elderly patient directly depends on psychological and mental comfort.

Diagnosis of the disease

To successfully combat the disease, it is necessary to determine the cause that caused it, and then choose the appropriate treatment; for this, the following studies are carried out:

• Manometry of the anal canal, which allows you to determine the tone of the sphincter;
• Endorectal ultrasonography, which will determine the thickness of the sphincters and their defects;
• Determination of the threshold sensitivity of the rectum.

After collecting anamnesis and examining the patient, specialists prescribe an adequate treatment method.

Treatment of fecal incontinence

Treatment methods for the disease include: medication, surgery and non-drug. The method of dealing with incontinence depends on the age of the patient and the severity of the lesion. In case of mild damage, a balanced diet and medications are prescribed that eliminate the causes of problems in the digestive system and also help to increase the tone of the sphincter muscles. When treating moderate fecal incontinence, special exercises may be prescribed to strengthen the muscles of the anus. They can be done at home, and the key to success is the regularity of gymnastics for 3-8 weeks. For sphincter training, the biofeedback technique or the use of electrical stimulators is also used to restore and improve the function of the muscles of the perineum and anal canal. For psychological problems, psychotherapeutic methods are used.

Surgical methods for treating the disease are used to correct traumatic defects in the anal muscles. If the sphincter nerves are damaged, an artificial anus consisting of a plastic ring filled with fluid can be implanted. In the most severe cases of fecal incontinence, the best option is to form a colostomy, in which the feces are collected in a special plastic bag attached to the abdominal wall communicating with the colon.

At the slightest manifestation of anal incontinence, you should not hesitate to immediately contact a specialist, since timely treatment will help you successfully cope with the disease in a short time and improve your quality of life.

Causes of fecal incontinence

Fecal incontinence is a condition that requires a comprehensive examination. Encopresis is rarely hereditary. If you experience several episodes of involuntary bowel movements over the course of 1 month, you should immediately consult a doctor. Finding out the cause without the intervention of a specialist and self-medicating is impractical and unsafe.

Causes of fecal incontinence in children

Involuntary defecation, like urination, in a child is justified only in infancy. As we grow older, the functions of the digestive tract and the ability to respond to physiological urges also develop. Uncontrolled bowel movement ceases to be a normal phenomenon - it becomes a pathology.

The task of parents is not to justify the fact of the development of fecal incontinence, not to explain it by any factors, but to rush to the pediatrician. After examination and questioning, he will refer you to a pediatric gastroenterologist or independently prescribe the necessary, and most importantly, competent treatment.
Childhood encopresis (as well as enuresis) is most often detected in preschool age, when the child undergoes a medical examination before entering an educational institution. Since upon reaching 6-7 years of age, children should already be able to control digestion and know how to behave correctly when they have the urge to defecate, the question of the psychological climate within the family is raised. They find out how favorable the situation is and whether violence is occurring there. Treatment of pathology requires the mandatory participation of a psychologist.

One of the reasons for fecal incontinence in a child:

Infection suffered in infancy (mainly associated with intestinal damage);
maternal illness during pregnancy;
smoking, alcoholism, difficult psychological conditions and exhausting work of a woman bearing a child;
intrauterine fetal hypoxia.

The listed factors have a detrimental effect on the body into which organs are just being laid. Underdevelopment of the sphincters of the digestive canal is an understandable complication in this case.

Also, children born as a result of problematic labor are more predisposed to encopresis. Its course can be complicated by entanglement of the umbilical cord, incorrect presentation and position of the fetus in the womb, and the need to use obstetric forceps. It has been revealed that children born during physiological labor rather than caesarean section are more likely to suffer from fecal incontinence.

Additional reasons:

Conflict situation in the family;
social and pedagogical neglect;
suffered fear, emotional shock;
congenital or acquired mental disorders - epilepsy, schizophrenia, neuroses, psychoses, hysteria, as well as combinations of these pathologies;
a tendency to shock - fecal incontinence in childhood is one of the manifestations of protest.

Taking into account these factors, at the stage of consultation and examination by a specialist, you need to inform about the features and difficulties that arose during pregnancy and/or childbirth.

Causes of fecal incontinence in adults

The etiological factors of fecal incontinence in children and adults are not particularly different. The only difference is that a child, due to his age, is more prone to demonstrative behavior, and therefore defecation can serve as a response even to a parental prohibition. In adults, encopresis occurs for the following reasons:

Malignant neoplasm of the rectum. Growing into the sphincter tissue, the tumor affects the nerve fibers. As a result, intestinal sensitivity and the patient’s ability to timely control the urge that arises are reduced. Removing a tumor (even if it is operable) does not promise an improvement in the process of defecation. Therefore, the best option for the patient is to create favorable conditions, first of all, the use of diapers, especially if they are going to be away from home. Considering the specifics of the pathology, it is preferable for the patient to minimize his stay in public places.

Digestive tract diseases. In gastroenterology, there are pathologies that lead, among other things, to scarring of rectal tissue. These include nonspecific ulcerative colitis, Crohn's disease. Pathologies affect the loss of elasticity of the rectum - it cannot withstand the urge to defecate and the influence of feces.

Constipation, metabolic disorders. A predisposing factor is a chaotic diet, the presence in the diet of an excessive amount of cereals, baked goods, potatoes, and fatty milk. Insufficient blood supply to tissues also leads to insufficiency of the digestive tract. First, constipation develops, then stretching of the intestines with feces, weakening of the sphincters and, as a result, it becomes difficult to restrain the urge to defecate.

Severe intoxication, condition after drug use. Alternate relaxation of all muscle groups leads to involuntary bowel movements.

Condition after complex surgical interventions, especially if the patient has drains removed.

Spinal cord injuries, previous stroke, condition after a spinal fracture, lack of sensitivity in the hip area. The patient does not feel the urge, cannot respond to them, defecation occurs involuntarily.

Fecal incontinence in women in half of all studied cases is the result of difficult childbirth, more often if an episiotomy was performed. Weakening of the pelvic floor muscles occurs due to multiple pregnancies and a large volume of amniotic fluid. Involuntary defecation in women occurs due to prolonged pressure of the enlarged uterus on the intestines, which creates a load on the sphincters and worsens their tone.

Also, encopresis in women occurs as a result of unprofessional tactics of obstetricians. Sometimes only during labor does the need for a caesarean section arise. However, gynecologists with little practice are not ready to admit that surgical intervention is required and continue to supervise the birth process. Then, due to the discrepancy between the size of the fetus and the proportions of the woman, her perineum is damaged.
Despite suturing directly in the delivery room, in the future there is a high probability of incontinence of urine, feces, and intestinal gases. In addition, recovery takes a very long time (up to 1 year).

The development of fecal incontinence in men, in addition to the tumor process and previous operations on the intestines, is facilitated by the following factors:

1. Hemorrhoids of severe forms. Inflammation of hemorrhoids, in turn, can be a consequence of excessive physical activity. Therefore, fecal incontinence also occurs among men. Also, increased physical activity is a separate risk factor for fecal incontinence.

2. Excessive use of laxatives. A particularly common cause of involuntary bowel movements in men over 60 years of age, when it is necessary to stimulate bowel function with medications.

3. Frequent enemas also cause involuntary bowel movements in men and women. Constant irritation of the intestinal walls negatively affects the motility of the digestive canal. As a result, it becomes more difficult to control it.

Abnormalities of intestinal development– a less common, but also relevant cause of fecal incontinence. Predisposing factors include disturbances in the structure of the brain and spinal cord. Also among the causes of uncontrolled bowel movements is diarrhea due to food poisoning or intestinal infection. The impact on the pathological condition is reduced to eliminating the root cause - immediately after relief of diarrhea, episodes of fecal incontinence do not occur.

Causes of fecal incontinence in older people

Among older people, fecal and urinary incontinence is the most common physical condition. Encopresis develops due to 3 main problems associated with natural aging of the body.

1. Problems with the functioning of the digestive tract. The main cause of fecal incontinence in older people is associated with disruption of intestinal metabolic processes. Low gastrointestinal motility contributes to the accumulation of food mass - constipation develops. A favorable condition is a sedentary lifestyle. Constipation is a precursor to fecal incontinence. Elderly people have difficulty influencing the sphincters - feces move and are evacuated involuntarily. Often - after the release of intestinal gases.

2. Mental disorders. In every 10 elderly people, irreversible changes occur in the centers of the brain. They entail disorders of memory, thinking, and coordination of movements. Also, against the background of a mental disorder, disruptions in the innervation of the intestine occur. However, the primary reason is problems with brain activity. Such pathologies include Alzheimer's disease, Parkinson's disease, senile dementia, manic-depressive syndrome, schizophrenia, and marasmus. Relatives need restraint in providing care for such a person, since encopresis is accompanied by other, no less severe symptoms.

3. Atrophy, weakness of the muscular system, characteristic of the aging process, leads to sphincter insufficiency. It becomes difficult to hold back your bowels during the urge.

The list of the most common causes of fecal incontinence in old age can be supplemented by impaired elasticity of the rectal muscles, its prolapse, and chronic intestinal diseases throughout life.

A specialist can reliably establish the causes of fecal incontinence in a patient of any gender and age, based on the results of instrumental and auxiliary types of research.

Encocution or fecal incontinence is a disorder in which the patient loses the ability to control the process of defecation. This condition does not threaten human life, but significantly worsens its quality. In most cases, the appearance of encoporesis in adults is associated with organic pathologies, including tumor processes and trauma. According to statistics, this disease is more often diagnosed in men.

What is fecal incontinence

Until recently, fecal incontinence was considered a common condition in old people in old age. However, upon closer examination of the problem, it turned out that they suffer from this disease at a younger age.

Interesting fact! About 50% of patients with this diagnosis are middle-aged men and women (over 45 years old). Less than a third of patients with encoporesis are elderly (75 years or older).

By this concept, doctors understand the inability to restrain the urge to have a bowel movement until the right moment arrives - going to the toilet. In this case, involuntary leakage of feces occurs, regardless of its consistency.

The mechanism of development of the disease is a disruption of the coordinated functioning of the sphincter and pelvic floor muscles, which hold feces in the rectum and maintain the intestines in tone. Normally, this occurs due to the activity of the autonomic nervous system, that is, the process of defecation without a conscious influence on the tone of the sphincter. It remains in a tense (closed) state during sleep and wakefulness. The average pressure in this area in men is slightly higher than in women, and the average values ​​for this value are 50-120 mm Hg.

Stimulation of defecation occurs due to irritation of mechanoreceptors in the rectum. It occurs due to the filling of this section of the intestine with feces. In response to irritation, a person experiences a Valsalva reflex, in which he feels the need to take a position suitable for bowel movements (squatting), after which he begins to contract the muscles of the anterior abdominal wall. At the same time, the rectum reflexively contracts, pushing feces out.

If it is impossible for a healthy person to perform an act of defecation, the person voluntarily contracts the puborectal muscles and the anal sphincter. At the same time, the ampulla of the rectum expands, the urge to empty the bowel movement weakens. With encoporesis in adults, a failure occurs at one of the described stages, and feces freely exit the anus.

Types of fecal incontinence

There are several types of encocution in adult patients, depending on how exactly the stool leakage occurs:

1. Constant (regular) incontinence without the urge to defecate. Most often, this type of disease occurs in children and elderly people who are in serious condition.
2. Incontinence, in which, shortly before the leakage of feces, the patient feels the urge to defecate, but there is no way to delay this process.
3. Partial incontinence, in which defecation occurs under certain stresses - coughing, sneezing, lifting heavy objects. In such situations, urinary and fecal incontinence is often observed.

Separately, age-related fecal incontinence is distinguished, which is diagnosed in elderly people due to degenerative processes in the body.

The classification of the disease also includes stages of progression of encoporesis. There are three in total:

Each type of encocution has its own characteristics. To begin treatment for this condition, the doctor will have to determine the causes of the pathology.

Causes of encoporesis in adults

Various situations can provoke the development of fecal incontinence. In adults, the main causes of pathology are associated with diseases and dysfunctions of the pelvic organs, pelvic floor, rectum and other parts of the intestine.

The most common causes of incontinence in middle-aged and older patients are as follows:

1. Constipation. If a person has bowel movements no more than 3 times a week, feces accumulate in the rectum, resulting in stretching and weakening of the sphincter muscles. The result of the process is a weakening of the holding capacity of the rectum.

1. Traumatic changes in the sphincter muscles (external or internal). Occurs as a result of injury or after rectal surgery. As a result of such changes, muscle tone is completely or partially lost, and fecal retention becomes problematic or impossible.

1. Failure of nerve endings and receptors in the rectum, as a result of which the patient does not feel that the rectum is full, or the body loses the ability to regulate the degree of tension of the internal and external sphincters. Childbirth, diseases and injuries of the central nervous system can lead to such problems. Often such disorders occur after a stroke or traumatic brain injury. Very often, such patients experience simultaneous urinary and fecal incontinence.
2. Decreased tone of the muscles of the rectum as a result of the formation of scars on it and partial loss of elasticity of the walls of the organ. Such situations arise after surgery on the rectum, radiation therapy, ulcerative colitis and Crohn's disease.
3. Dysfunction of the pelvic floor muscles due to impaired nerve conduction or muscle failure. These may be disorders such as rectocele, rectal prolapse, postpartum weakening of the pelvic floor muscles in women. A common combination is episiotomy and fecal incontinence. The pathology is detected immediately after childbirth, which required dissection of the perineum, or several years later.

1. Hemorrhoids often cause partial fecal incontinence. Hemorrhoids, especially if they are located under the skin around the anal sphincter, do not allow it to close completely. As a result, stool leaks. Over time, with a long and chronic course of the disease, progressive prolapse of hemorrhoids, the decrease in sphincter tone increases, and the symptoms of incontinence intensify.

Interesting fact! Experts have found that habitually holding back stool can weaken the anal sphincter and lead to stretching of the rectal ampulla. If you put off going to the toilet too often and wait for several hours at a time, you may eventually experience fecal incontinence.

A considerable proportion of diseases are caused by mental and psychological disorders. Loss of control over bowel movements occurs in patients with various forms of psychosis, schizophrenia, and neurosis. Sudden leakage of feces can occur during a panic attack or hysteria, or an epileptic attack. Patients with senile dementia also lose control over bowel movements.

Diagnostics

To choose ways to treat fecal incontinence, the doctor will need to find out many things. To begin with, a survey is conducted during which the doctor finds out the characteristics of the condition:

• in what situation does fecal leakage occur?
• how long has this been observed and with what frequency;
• whether or not the urge to defecate is felt before leakage occurs;
• stool of what consistency cannot be held;
• the volume of excreted feces, with or without gas it comes out.

The specialist also needs to know whether there have been strong emotional shocks or traumas recently, whether there is confusion of thoughts or disorientation in space, what medications he is taking, what his diet consists of, whether there are any bad habits and whether incontinence is accompanied by additional symptoms.

To establish the exact picture and causes of incontinence, a complex of diagnostic instrumental studies is used:

• anorectal manometry to measure the sensitivity and contractility of the anal sphincter;
• MRI of the pelvis to visualize the condition of the pelvic day muscles and anal sphincters;
• defectography (proctography) to determine the amount of feces that the rectum is capable of holding, and to identify the characteristics of the bowel movement process;
• electromyography to study the correct functioning of the nerves responsible for the contractility of the anal sphincter muscles;
• sigmoidoscopy and ultrasound of the rectum, with which you can detect abnormalities in the structure of this part of the intestine, as well as detect pathological neoplasms (scars, tumors, polyps, etc.).

Additionally, patients are prescribed comprehensive laboratory diagnostics: blood, stool, and urine tests (general and biochemical). Only after this the doctor decides how and how to treat encoporesis.

Important! To eliminate fecal incontinence, it is necessary first of all to eliminate the diseases that cause weakening of the anal sphincter and pelvic floor muscles, and to get rid of associated pathologies.

Treatment methods for fecal incontinence

In adult patients, treatment of fecal incontinence requires a comprehensive approach. The patient is advised to review the diet, adjust physical activity, practice regular pelvic floor muscle training, take special medications, and avoid some medications altogether. Surgery is also used to eliminate this problem.

Drug therapy

Drug therapy is used mainly for incontinence, which occurs against the background of diarrhea. Several groups of drugs are used:

• anticholinergics, which include atropine and belladonna - to reduce intestinal secretion and slow down peristalsis;
• medications with opium derivatives (Codeine and painkillers) or Diphenoxylate - to increase intestinal muscle tone and reduce peristalsis;
• medications that reduce the amount of water in stool - Kaopectate, Metamucil, Polysorb and others.

Classic drugs - Loperamide, Imodium - also have a good antidiarrheal effect. Prozerin injections and the drug Strychin help get rid of the manifestations of encoporesis. Taking vitamins (ATP, group B and others) will also be useful.

Important! To restore stool, patients with encoporesis are not recommended to take antacids, as well as medications that can cause diarrhea.

For mental and psychological problems, the patient is prescribed sedatives, sedatives and tranquilizers that help control behavior. They are released only with a doctor's prescription.

Diet

Doctors call diet therapy the basis of therapeutic measures for anal sphincter failure. Without compliance with certain nutritional standards, treatment will be ineffective. Main objectives of the diet:

• restoration of stool (exclusion of diarrhea and constipation);
• reduction in stool volumes;
• normalization of intestinal motility.

The first priority is to exclude from the menu foods that cause softening of the stool. These include sugar substitutes (sorbitol, xylitol and fructose), dairy products, especially whole milk and cheeses, nutmeg, alcoholic beverages, coffee. It is advisable to reduce to a minimum or completely eliminate hot spices, lard, fatty meats, and citrus fruits from the diet. You should also refrain from smoking.

Important! Patients are recommended to keep a diary in which they should record information about the foods they eat, the time they were taken and the volume of portions. It should also be noted at what moments incontinence occurs. This will help eliminate foods that irritate the intestines from the menu.

The basis of the diet should be cereals, fresh fruits and vegetables, whole grain bread or wholemeal flour. They contain a lot of fiber, which helps thicken stool. Fermented milk drinks without additives will also be beneficial. If there is a lack of fiber, the diet includes bran and whole wheat grain flakes. It is advisable to eat food often and little by little, up to 5-6 times a day. The intervals between meals should be equal.

Exercise therapy

A complex of special gymnastics (Kegl exercises) is used to strengthen the sphincter and pelvic floor muscles. It includes the following exercises:

• contraction and relaxation of the anal sphincter - repeat 50-100 times a day;
• retraction and protrusion of the abdomen - 50-80 repetitions per day;
• tension of the pelvic muscles in an inward and upward direction while sitting with crossed legs.

Such exercises strengthen the pelvic muscles equally well in men and women. They can be performed in several variations: quickly alternate between contraction and relaxation, hold the muscles in a tense state for 5-15 seconds and relax for 5-7 seconds, and so on. How to do exercise therapy using Kegl correctly is shown in the video:

At the initial stage, the doctor can connect special sensors to the patient’s body, which will indicate which muscles are involved in the work during exercises. This way you will be able to understand how to perform gymnastics correctly.

Patients recovering from a stroke are also shown a set of exercise therapy exercises, but in addition to the techniques described above, attention is paid to the development of fine motor skills. It will be useful for them to squeeze or roll small balls in their palms, do modeling, and put together mosaics from medium-sized elements. All this will allow you to quickly restore neural connections in the brain and get rid of the unpleasant consequences of the disease.

Important! Gymnastics does not give instant results. The effect becomes noticeable after a few weeks from the start of daily training, and is consolidated after 3-6 months.

Surgery

Surgical intervention is used when previously described methods are ineffective. This treatment works well after surgery on the rectum, which caused complications in the form of encoporesis, after injuries (including postpartum) and for incontinence caused by a tumor process in the rectum.

To eliminate the incompetence of the anal sphincter, use:

• Sphincteroplasty, during which the sphincter is reconstructed. This method is used for injuries to the muscle ring, its complete or partial rupture.
• Straight sphincter surgery, in which the sphincter muscles are attached more tightly to the anus.
• Installation of an artificial sphincter, consisting of a cuff that covers the anus and a pump that supplies air to the cuff. This device holds the anus closed, and if necessary, the patient deflates the cuff (releases air from it) to have a bowel movement.

• Colostomy, during which the large intestine is cut off and brought to an opening in the anterior abdominal wall. Feces are collected in a special bag - a colostomy.

The type of surgical intervention that will be applied to the patient is selected based on the causes of encoporesis. Only the attending physician can choose how to treat the disease.

The following tips will help you cope with the difficulties in everyday life that inevitably arise in patients with encoporesis:

1. Before leaving the house, try to empty your bowels.
2. It is worth planning walks and visits 1-2 hours after the main meal or later.
3. Before leaving home, make sure that you have wet wipes and a change of clothes in your bag.
4. If the risk of fecal leakage is high, it makes sense to use disposable underwear instead of regular underwear.
5. When you are away from home, the first thing you should do is find out the location of the toilet room.
6. Use special underwear or diapers.

Note! In pharmacies you can buy drugs that can help reduce the specific smell of feces and gases.

Anal sphincter incompetence is an extremely unpleasant disease that many patients prefer to keep silent about. The first step on the path to recovery is seeing a doctor. You can come to a therapist or proctologist with such a problem. If incontinence occurs after childbirth in women, they should consult a gynecologist. The sooner you pay attention to the pathology and take measures to eliminate it, the higher the chance of restoring the functions of the anal sphincter or at least preventing further progress of the disease.

There is no point in trying to correct the situation using folk remedies. Most of them are ineffective and sometimes downright dangerous. Even if you want to try to improve your condition through folk remedies, it is recommended to start taking them after consulting with your doctor.