Assoc. Prof. Dr. Mustafa Kaplan from the Gastroenterology Department of Memorial Kayseri Hospital gave information about the problem of fecal incontinence and treatment methods.
Fecal incontinence, which can develop due to muscle and nerve damage, diarrhea, constipation, various diseases and old age, negatively affects the person psychologically and sociologically over time. In developed countries, especially 2% of people over the age of 65 face the problem of fecal incontinence. In childhood, fecal incontinence can occur in children with neurological and physical developmental retardation and in children who have to face excessive anxiety and stress. The problem of fecal incontinence can be eliminated with personalized treatment methods and measures to be taken. Assoc. Dr. Mustafa Kaplan from Memorial Kayseri Hospital Gastroenterology Department gave information about the problem of fecal incontinence and treatment methods.
Bowel control is lost
Fecal incontinence is the unexpected leakage of feces from the rectum, the last part of the intestine and the buttocks, as a result of uncontrolled bowel movements. Fecal incontinence, also called anal incontinence, is a problem that can progress with different pictures ranging from a small amount of fecal leakage during occasional flatulence to complete loss of bowel control. This happens against the person's will and the stool comes out through the anus. Normally, the ability to hold stool (continence) is a natural result of the normal functioning of the rectum, anus and nervous system. Two groups of muscles in the wall of the anus and rectum hold the stool in the rectum and prevent it from leaving. Normal continence also includes the ability to sense the presence of stool in the rectum (called rectal sensation) and the ability to loosen and store stool when bowel movement is not appropriate.
Fecal incontinence can be caused by
As people age, the sphincter muscles weaken over time. In addition to muscle weakening, fecal incontinence is often caused by changing bowel habits (diarrhea, constipation) and conditions that affect the ability of the rectum and anus to hold stool. In women in particular, the sphincter muscles or the nerves that supply them can be damaged during vaginal delivery, trauma or anal surgery. Nerves can also be damaged in patients with diabetes or in people affected by nerve disorders after a stroke. The rectal wall can become stiff after radiation therapy or in patients with Crohn's disease. In these patients, the rectum cannot stretch as much as it should, so excess stool can leak out. Other conditions such as rectal prolapse (rectal prolapse) or rectal protrusion into the vagina (rectocele) can also cause fecal incontinence. In addition, fecal incontinence can occur as a result of deformations in the anus (injury, insertion of an object into the anus). Surgical interventions in the anus (hemorrhoid, fistula, fissure surgeries) are an important cause of fecal incontinence. Nerve damage in the anal area as a result of nerve diseases can cause fecal incontinence. Loss of strength in the muscles in advanced ages is also an important cause of fecal incontinence.
Treatment options are applied depending on the cause
There are effective treatments for fecal incontinence. Fecal incontinence treatment helps to improve or restore bowel control. Depending on the cause of fecal incontinence, treatment may include changing eating habits, medication, special exercises to help better control the bowels, or surgery. Foods that can cause diarrhea and worsen fecal incontinence include spicy and fatty foods, dried or smoked meat and dairy products (especially if lactose intolerant). Drinks containing caffeine and products with artificial sweeteners can act as laxatives. There are anti-diarrhea medications (e.g. loperamide) that effectively prevent diarrhea. If constipation is present, fiber-rich foods should be eaten and fiber supplements taken. On the other hand, if diarrhea is present, the doctor may recommend anti-diarrheal medicines or fiber supplements to help hold in stool. If fecal incontinence is due to a lack of anal sphincter control or decreased awareness of the urge to defecate, therapies in the form of exercises can be done to help increase muscle strength around the anus. In some cases, bowel training can mean learning to go to the toilet at a certain time of the day. For example, the specialist may give advice on making a conscious effort to have a bowel movement after eating. If stools are passed frequently and in large quantities, moisture barrier creams should be used to prevent direct contact between irritated skin and stool. Make sure the area is clean and dry before applying the cream. Non-medicated talcum powder can also help relieve anal discomfort. Cotton underwear and loose clothing should be preferred and soiled underwear should be changed frequently. If pads or adult diapers are used, make sure they have an absorbent wick layer on top. If these measures are not effective, surgery or some interventional procedures may be considered.
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