Faecal incontinence and symptoms
Faecal or anal incontinence is a highly disabling disorder characterised by the involuntary and uncontrolled loss of faeces and intestinal gases. Those who suffer from it cannot control all or part of the defecation, which leads to the uncontrolled release of waste material. This disorder affects 1-2% of the population, more frequently those over 40 and especially women, as they are subject to increased laxity of pelvic and abdominal muscles (caused by birth injuries). Faecal incontinence is a highly disabling disorder that has a heavy impact on the quality of life of those affected and limits their social relationships, fuelling stress and anxiety related to the disorder.
Faecal incontinence can be either active (when the person feels the stimulus, but is unable to restrain it) or passive (when the person does not realise that he or she is losing his or her stool). There are several systems for assessing the degree of incontinence, which can be classified as follows:
- Soiling: soiling of the undergarments caused by the loss of small amounts of mucus, faeces or other anal/perianal secretion, unnoticed or in any case uncontrollable voluntarily;
- Gas incontinence;;
- Moderate incontinence: significant loss of liquid stools and gases;
- Complete incontinence: total inability to control defecation with loss of solid, liquid and gas stools.
Causes leading to faecal incontinence
The causes of faecal incontinence can be multiple, the most common:
- RECTAL PROLAPSE AND RECTOCELE
Characterized by a loosening of the rectal tissues that protrude out of the anus or through the vagina (rectocele). - DEFECATION DISORDERS AND INTESTINAL INFLAMMATORY DISEASES
Faecal incontinence is seen with a clear prevalence in patients with any defecation disorder (constipation, chronic diarrhoea and acute diarrhoea) and in the presence of inflammatory bowel diseases that progressively weaken the muscles of the rectum. - URINARY INCONTINENCE
Urinary incontinence may sometimes precede faecal incontinence. - NEUROLOGICAL DISORDERS AND NEURODEGENERATIVE DISEASES
Faecal incontinence is closely related to lesions of the nerves that control the defecation stimulus. Neurological disorders and neurodegenerative diseases (such as stroke, multiple sclerosis and diabetic neuropathy) are responsible for damage to the abovementioned nerve sheaths and therefore increase the risk exponentially. - SURGICAL OPERATIONS AND RADIOTHERAPY TREATMENTS
Some surgeries may stiffen the lower intestinal tract, resulting in a total or partial inability to control the defecation impulses. Radiotherapy treatments for tumours in the anal area can also cause a stiffening of the rectum and lead to the onset of the disorder. - PELVIC FLOOR TRAUMA DURING CHILDBIRTH
Obstetric injury from long and difficult childbirth can result in injury to the pelvic and/or sphincter floor muscles.
The importance of prevention
As with any other disorder, prevention is critical to reducing the incidence of disease and mortality among individuals. The prevention and treatment of faecal incontinence is achieved by paying particular attention to certain conditions that can favour and foster it. Good nutrition is the first essential step (following a varied diet, avoiding spicy and smoked foods, caffeine, alcohol, and drinking the correct daily amount of water) in order to facilitate the passage of stools and avoid inflammatory states. In addition, regular and moderate physical activity, but also paying proper attention to intimate hygiene through the use of specially formulated intimate detergents, and finally, seeking treatment rapidly in the presence of infections in the pelvic and/or perineal area.
Diagnosis and therapy
The diagnosis of faecal incontinence begins with an in-depth anamnesis of the patient, in order to know their lifestyle, eating habits, medication taken, frequency and characteristics of evacuations, surgical operations undergone. Digital exploration is then carried out to highlight any anomalies and assess the strength of the sphincter muscle. Subsequently, the proctologist will perform further instrumental analyses such as anoscopy or rectoscopy, in order to allow a more precise definition of the elements responsible for the dysfunction.
In order to obtain a comprehensive clinical picture, the proctologist may request further tests (balloon expulsion test, endoanal ultrasound, colonoscopy, X-ray, MRI) and direct the patient towards the most appropriate treatment. There is however no universal cure to combat faecal incontinence, as the disorder has a multi-factorial origin. While for some patients it is enough to change their eating habits and simply follow a medical treatment, for others it is necessary to use biofeedback or to undergo a surgical operation.
The contents of this page are for informational purposes only and should in no way replace the advice, diagnosis, or treatment prescribed by your physician. Responses to the same treatment may vary from patient to patient. Always consult your doctor regarding any information related to diagnoses and treatments, and meticulously follow their instructions.
