Sievering Surgical Clinic

Sieveringer St 9, A-1190 Vienna Tel: 328 8777

Gastroenterology Unit

Stool incontinence

Diagnosis & Treatment

Stool incontinence

Patient information on digestive disorder

AKA:

Definition

Stool incontinence is the uncontrollable discharge of gas, mucus, liquid stool or solid components. It means that you are not the emptying of the bowel can restrain arbitrary. Although fecal incontinence is common, many patients do not trust a long time to go to the doctor, although they could well have helped.


First, the doctor can find out what is the cause of incontinence. There are several medications that help. The time in which food travels to the elimination through the intestines, for example, be extended.
Sometimes surgery is the best way to remedy this.


The most common causes of sphincter incontinence are changes in the region of the anal canal, often accompanied by nervous disorders in this region. These include by sphincter injury:

  • previous operations,

  • Injuries,

Births.





The sphincter muscle weakness, usually associated with a descent of the pelvic floor (perineal descent). It mainly affects patients with chronic constipation and frequent press attempts to achieve defecation. The advanced hemorrhoidal with the sensitive continence organ, and therefore unnoticed loss of sparse protuberances chair.



The sensitive innervation which the patient can perceive sensations such as urge to defecate, stool or rectal fullness of the passage of stool through the anal canal at all (sensory incontinence).



Few patients with such symptoms confide in a doctor - this followed mainly due to the embarrassment of the problem and because of the frustration of living through possibly inadequate investigation of a non-goal-oriented treatment. Presumably there is a large number of unreported cases of patients with incontinence withdrawn with their problem, as social misfits live.



In the U.S. there are 3 million people affected. The prevalence in the population reached more than 65 years, 11/1000 in men and 13/1000 in women. At 45 years old women, the incidence of fecal incontinence eight times higher than the same age in men.

 

Grade

  • Grade I: incontinence for gas, no stool smearing

  • Grade II: loss of control for wind and liquid to mushy stool

  • Grade III : Permanent lubrication chair


Causes of stool incontinence

The reasons for the lack of bowel control are numerous: the case of diarrhea , it may happen that the defecation takes place involuntarily.

In age, the ability of the gut closure

In women, childbirth is often damaged the sphincter. This notice does not immediately after birth. Often the incontinence occurs only much later in appearance .

By a diabetes can cause nerve damage , interfere with the locking mechanism.

After operations on the rectum , e.g. due to hemorrhoids , incontinence can occur .

An incident of the rectum can lead to incontinence.

In severe constipation , it may happen that liquid stool passed spontaneously to the hard stool masses going on.

The reasons for the lack of bowel control are numerous: the case of diarrhoea, it may happen that the defecation takes place involuntarily.

In age, the ability to hold stool weakens due to descendeing peroneum and sacral nerve damage due to vertebro-stenosis.

In women, childbirth is often damaged the sphincter. This notice does not immediately after birth. Often the incontinence occurs only much later in appearance.

By a diabetes can cause nerve damage, interfere with the locking mechanism.

After operations on the rectum, e.g. due to haemorrhoids, incontinence can occur.

Rectal trauma, in some cases self-inflicted can lead to incontinence.

In severe constipation, it may happen that liquid stool is pushed spontaneously through harder stool and leaks.

Investigation

 

Necessary investigations: the gradual approach is ideal in the following order:

History and physical examination . When asked about the medical history should not miss drugs . Gives the experienced examiner already crucial clues to the possible cause and the severity of the illness and decide the further course study .



Proctologische Investigation : Includes not only the visit and the finger test , but necessarily , an endoscopic examination with the Proctoskop . Obligate a study to assess the anatomy of the muscle is firing , the endosonography .


Pressure measurement of sphincter apparatus: If using a probe. At the same time to draft a balloon through the rectal filling sensations and the reflex action rektoanale Relax ( = normal relaxation of the internal sphincter during the filling of the rectum) are checked .


Radiographic examination of the emptying process ( Defäkografie ) : Is extremely valuable, if incontinence is present with simultaneous evacuation of a suspected malfunction or failure of the inner Rektumvorfall pelvic floor or the rectum during evacuation . ( Rectocelenbildung = evagination of the rectum ) .

 

Differential diagnosis

Severe generalised muscle wasting is also seen as part of a number of degenerative neurological and muscle diseases and in cardiac failure.

Treatments

Regular bowel movements at specific times is favorable. This exercise can be . Also, we should eat plenty of fiber . This makes the chair is formed , but soft.

Basis of any treatment are simple , non-operative measures , supplemented in some cases by appropriate operations . The therapeutic concept is designed by nature to that specialist, who conducted the investigation , and has explained to the patient the cause of his symptoms enough .

Based therapy and pelvic floor exercises chair anal sphincter training regulation and the prevention of constipation and severe straining while evacuating stool .

Biofeedback Training

Using a sensor inserted into the anal canal , the patient 's behavior on-screen control of the various portions of his closing muscles during pressing and draining , and correct lost or abnormal reflexes , and relearn .

Increase the amount of fiber in the diet high in vegetables, salad , or fiber-rich fruits (eg oranges , pineapple) . Bananas, pears contain little fiber .

Take 2 x daily 1-2 tablespoons flax seeds (or flax seeds , brown seeds ), not crushed , not ground , for example, when added to yogurt , butter, milk , cereal , applesauce , mashed potatoes, etc. Flaxseed bread is not enough! The grains contained therein are burned , they no longer swell . Shredded flaxseed also has no effect , because flax seed swells only as long as the fibrous capsule is intact ! You need to take Flaxseed to drink no more , as usual , to quench thirst . Grains can not chew ! Previous soaking is not necessary.

Strive to chair shaped ; "normal " is the " sausage " (no " balls " , not mushy or " muddy " chair) . The rectum should be emptied in general, without having to press strongly .

Do not try to force desperately daily bowel movement. Note the above rule of thumb.

Go to the toilet when you feel the urge to defecate , make it short, drain, wash up . No " cigarette length ," no newspaper reading.

Looking at the nearest toilet to defecate ; hold back no longer the chair : you otherwise permanently paralyze the evacuation reflex and get a blockage . The retained " plug" your rectum promotes suffering.

Strengthen your abdominal muscles through simple gymnastic exercises: Lie on your back , legs tighten , lay hands on the neck , torso erect .

 

| 25.01.2011 | Read more | Print |

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