diease

Bowel Incontinence


Bowel Incontinence overview and Definition

Faecal incontinence refers to the involuntary bowel movemnets that cannot be controlled. Stool passes spontaneously without any planned action.


Epidemiology

people of age more than 65 years of age is prone for the disease.

young children physical activity also are the victim to bowel incontinence


Pathophysiology

Faecal incontinence occurs when the normal anatomic and physiologic function of the body gets interrupted. Incontinence usually occurs from the multiple fcarors and it is not concerned to the single factor. The internal anal sphincter function is to cause the pressure during the resting phase and also it enhances the action of external sphincter , the anal mucosal folds, and the anal endovascular cushions. Disruption of the external sphincter results in urge related disorder or diarhhoea related disorder. Damage to the endovascular cushions results in dysfunction of the anal seal and sampling reflex. The ability of the rectum to perceive the presence of stool leads to the rectoanal contractile reflex response, an essential mechanism for maintaining continence.Pudendal  neuropathy can diminish rectal sensation and lead to excessive accumulation of stool, causing  faecal impaction, mega-rectum, and fecal overflow. The puborectalis muscle plays an integral role in maintaining the anorectal angle. Its  nerve supply is independent of the sphincter, and its precise role in maintaining continence needs to be defined. Obstetric trauma, the most common cause of anal sphincter disruption, may involve the EAS, the IAS, and the pudendal nerves singly or in combination. It remains unclear why most women who sustain obstetric injury in their 20s or 30s typically do not present with fecal incontinence until their 50s. There is a strong need for prospective, long-term studies of sphincter function in nulliparous and multiparous women


Clinical signs & symptoms

loosy stool

difficulty in passing the stool

pain while evacuating 

excessive straining to pass the stool

Bloating and gas


Differential Diagnosis

Blood test,urine test  and stool test might be used to detect the dysfunction of bowel.

                   Blood test- can show signs of anaemia,inflammation and infection.

  • Stool tests can show the presence of blood and signs of infection and inflammation.
  • Urine test – diseases such as Diabetes mellitus type 2

Bowel function diseases:

It involves the Inspection of the anal,pelvic floor and rectum .

  • anorectal manometry—a test that checks how sensitive your rectum is, how well it works, and how well the anal sphincter work
  • defecography—an  xray  of the area surrounding the anus and rectum to see how well you can hold and release stool
  • Electromyography—a test that checks how well the muscles and nerves of your anus and pelvic floor are working

Endoscopy

Endoscopy helps to look inside your anus, rectum, and colon  for signs of inflammation and digestive tract functions problems that may be causing your fecal incontinence. Endoscopies for fecal incontinence include

  • Anoscopy
  • colonoscopy
  • flexible sigmoidoscopy
  • rectoscopy—a procedure similar to an anoscopy to look inside your rectum

Imaging tests

To look for problems in the anus, pelvic floor, or rectum that may be causing your fecal incontinence, your doctor may perform an imaging test such as

  • Lower Gastrointestinal series
  • Magnetic resonance imaging
  • ultrasound


Prognosis

The prognosis is good when the triggering factor is made to subside.


Prevention

Intake  lots of water and other fluids. You may be able to treat diarrhea at home using over-the-counter medications, such as loperamide

stay hydrated

practise physical exercises

reduces the stress and practise yoga

avoid the foods that results in constipation mainly junk foods

be physically active

 


Reference

https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/diagnosis-treatment/drc-2

https://www.niddk.nih.gov/health-information/digestive-diseases/bowel-control-problems-fecal-incontinence/diagnosi

https://www.medicalnewstoday.com/articles/165583

https://my.clevelandclinic.org/health/diseases/14574-fecal-bowel-incontinence

https://www.nhs.uk/conditions/bowel-incontinence/