Faecal Incontinence

Faecal incontinence, also known as bowel incontinence, is the inability to control bowel movements, resulting in involuntary leakage of stool. It is a common condition that affects millions of people worldwide, with a significant impact on quality of life.

Causes of Faecal Incontinence

• Damage to the anal sphincter muscles: Trauma during childbirth, surgery, or injury can damage the anal sphincter muscles, leading to faecal incontinence.
• Nerve damage: Conditions such as diabetes, stroke, and spinal cord injuries can damage the nerves that control bowel movements, resulting in faecal incontinence.
• Neurological disorders: Conditions such as multiple sclerosis, Parkinson's disease, and dementia can affect bowel control and lead to faecal incontinence.
• Gastrointestinal conditions: Conditions such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and gastroesophageal reflux disease (GERD) can increase the risk of faecal incontinence.
• Aging: Faecal incontinence is more common in older adults due to age-related changes, such as decreased muscle tone and nerve function.
• Surgery: Certain surgeries, such as haemorrhoidectomy or rectal surgery, can increase the risk of faecal incontinence.

Types of Faecal Incontinence

• Urge incontinence: The inability to reach the toilet in time, resulting in involuntary leakage of stool.
• Passive incontinence: The involuntary leakage of stool without a sensation of urgency or awareness.
• Faecal seepage: The involuntary leakage of small amounts of stool, often accompanied by gas and mucus.

Symptoms of Faecal Incontinence

• Uncontrolled passage of stool or gas
• Leakage of stool or mucus from the anus
• Staining or soiling of underwear
• Embarrassment and social isolation
• Anxiety and depression

Diagnosis of Faecal Incontinence

Diagnosis is typically made through a combination of:

• Medical history: A thorough review of medical history, including any previous surgeries or conditions that may contribute to faecal incontinence.
• Physical examination: A physical examination to assess anal sphincter tone and sensation.
• Anorectal manometry: A test to measure the strength of the anal sphincter muscles.
• Endoscopy: A procedure to visualize the rectum and anus.
• Imaging studies: Such as ultrasound or MRI, to evaluate the anal sphincter muscles and surrounding tissues.

Treatment of Faecal Incontinence

Treatment options may include:

• Bowel habit training: Establishing a regular bowel routine to help manage symptoms.
• Dietary changes: Avoiding foods that can exacerbate symptoms, such as spicy or fatty foods.
• Medications: Such as loperamide or fibre supplements, to help regulate bowel movements.
• Biofeedback therapy: A type of therapy that helps individuals become aware of and control their bowel movements.
• Surgical options: Such as sacral nerve stimulation or anal sphincter repair, may be considered in severe cases.

Management of Faecal Incontinence

To manage faecal incontinence, individuals can:

• Use protective garments: Such as adult diapers or pads, to protect clothing and skin.
• Practice good hygiene: Regularly cleaning the anal area and using fragrance-free soap and water.
• Avoid irritants: Avoiding foods, medications, or substances that can exacerbate symptoms.
• Seek support: Joining a support group or seeking counseling to cope with emotional and social challenges.

Frequently Asked Questions (FAQs)

What is faecal incontinence?
Faecal incontinence is the involuntary loss of control over defecation, resulting in unintended passage of stool.

What are the causes of faecal incontinence?
Causes may include damage to anal sphincter muscles, nerve damage, or certain medical conditions such as diabetes or inflammatory bowel disease.

Is faecal incontinence a common condition?
Faecal incontinence can affect up to 1 in 10 people, although prevalence may vary depending on age and other factors.

Can faecal incontinence be treated?
Treatment options are available, including lifestyle modifications, pelvic floor exercises, and possibly surgery, depending on the underlying cause.

What lifestyle changes can help manage faecal incontinence?
Dietary changes, bowel habit training, and pelvic floor exercises may help manage symptoms.

Can medication contribute to faecal incontinence?
Certain medications, such as laxatives or antidiarrheal drugs, may exacerbate or contribute to faecal incontinence in some individuals.

Is faecal incontinence more common in older adults?
Faecal incontinence tends to increase with age, affecting a higher proportion of older adults.

Can faecal incontinence be a symptom of an underlying neurological condition?
Yes, certain neurological conditions, such as multiple sclerosis or spinal cord injuries, may contribute to faecal incontinence.

Are there any surgical options for treating faecal incontinence?
Surgical procedures, such as sphincteroplasty or sacral nerve stimulation, may be considered in some cases where other treatments have failed.

Can faecal incontinence affect mental health?
Faecal incontinence can potentially contribute to emotional distress, anxiety, and depression in affected individuals.