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.