Medical expert of the article
New publications
Stool incontinence
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Stool incontinence is a loss of control over stool. This state is often mistakenly perceived as an inevitable manifestation of old age. Clinically incontinence is expressed by frequent or constant leakage of semi-formed feces, as well as the passage of the formed feces 1-2 times a day in bed or on clothes.
[What causes incontinence?
Stool incontinence can be the result of injuries or diseases of the spinal cord, congenital disorders, accidental damage to the rectum and anus, prolapse of rectum, diabetes, severe dementia, fecal infringement, extensive inflammation, tumors, obstetric injuries and operations involving dissection or enlargement anal sphincter. Also, stool incontinence can be due to such processes: the use of laxatives, frequent enemas, proctitis, prolapse and cancer of the rectum, Crohn's disease, insufficient absorption of fluid, ischemic colitis. Fecal incontinence can be a consequence of a violation of control over defecation from the nervous system.
How to recognize stool incontinence?
In case of physical examination, it is necessary to evaluate the closing function of the sphincter and the perianal sensitivity and to exclude the calorie infringement. In the examination, an ultrasound of the anal sphincter, MRI of the pelvis and abdominal cavity, electromyography of the pelvic floor and anorectal manometry are expedient.
What do need to examine?
How to examine?
How is incontinence treated?
Treatment of incontinence of feces includes a program of preparation of the intestine for the development of intentional urge to defecate. The program includes the consumption of an adequate amount of liquid and a sufficiently large volume of food. Exercise in the toilet or use of other conventional stimulants of defecation (eg, coffee) stimulate defecation. You can also use a suppository (eg, glycerol, bisacodyl) or phosphate enemas. If regular urges for defecation are not restored, the use of a slag-free diet and oral loperamide can reduce the frequency of defecation.
Simple exercises for the perineum, in which the patient repeatedly reduces the sphincter, perineal muscles and gluteal muscles, can strengthen these structures and contribute to the restoration of the sphincter function, especially in light cases. It is necessary to use the principle of biofeedback (training the patient to optimize the function of the sphincter and better perception of physiological stimuli) before recommending surgical treatment in patients with good motivation who understand the meaning of the problem and follow the instructions clearly and who retains the anal sphincter's ability to perceive irritation in the rectum . Approximately 70% of these patients respond to biological feedback.
Deficiency of the sphincter can be directly sutured. In the absence of conditions for the restoration of the sphincter, especially in patients under 50 years of age, displaced m.gracilis (a thin thigh muscle) can be used for plasty . In some centers, the pacemaker m.gracilis is used and, thus, an artificial sphincter is formed; such or similar experimental studies are conducted only in several centers in the United States as experimental protocols. Alternatively, a Tiersch wire or other material that can be used around the anus can be used.
If all the methods used are ineffective, the indications for colostomy are set.
How to care for a person, if there is fecal incontinence?
In the care of patients, the prevention of reflex emptying of the large intestine is important. So, if the stupas comes after the morning tea, then the reception should be combined with staying on the toilet or night utensils. High-calorie meals are shown in small portions throughout the day; the patient is placed on the ship, ensuring thorough hygiene of the perineum (wash every 2-4 hours, treatment of the anus with vaseline or protective cream, timely replacement of bed linen and bed linen); use funds that delay the emptying of the intestines, enemas (preferably from chamomile broth), occasionally suppositories. It is necessary to ensure frequent (6-8 times a day) ventilation, if possible using deodorants.