Summary about Disease
Bowel incontinence, also known as fecal incontinence, is the inability to control bowel movements, resulting in the involuntary leakage of stool. This can range from occasionally leaking a small amount of stool or gas to a complete loss of bowel control. It can be embarrassing and significantly impact a person's quality of life, affecting their social, emotional, and physical well-being.
Symptoms
Inability to delay bowel movements
Leaking stool when passing gas
Soiling underwear
Urgent need to have a bowel movement
Diarrhea
Constipation
Gas and bloating
Feeling of incomplete evacuation
Skin irritation and soreness around the anus
Causes
Bowel incontinence can be caused by a variety of factors, including:
Muscle damage: Damage to the anal sphincter muscles (muscles that control bowel movements) due to childbirth, surgery, or injury.
Nerve damage: Conditions that damage the nerves that control the anal sphincter muscles, such as diabetes, multiple sclerosis, stroke, or spinal cord injury.
Constipation: Chronic constipation can lead to impacted stool, which can stretch and weaken the anal sphincter muscles or leak around the impacted stool.
Diarrhea: Frequent diarrhea can overwhelm the anal sphincter muscles, leading to incontinence.
Loss of rectal storage capacity: Conditions that reduce the rectum's ability to store stool, such as inflammatory bowel disease (IBD) or radiation therapy.
Pelvic floor dysfunction: Weakness or dysfunction of the pelvic floor muscles, which support the rectum and anus.
Rectal prolapse: When the rectum sags down into the anus.
Cognitive impairment: Conditions such as dementia or Alzheimer's disease can make it difficult for individuals to recognize the need to defecate or to reach a toilet in time.
Medications: Some medications can cause diarrhea or constipation, contributing to incontinence.
Medicine Used
Medications used to manage bowel incontinence depend on the underlying cause and symptoms. Common medications include:
Anti-diarrheal medications: Loperamide (Imodium) and diphenoxylate/atropine (Lomotil) can help reduce the frequency of bowel movements and firm up the stool.
Bulk-forming agents: Psyllium (Metamucil) or methylcellulose (Citrucel) can help add bulk to the stool, making it easier to control. They are most effective for mild to moderate incontinence.
Laxatives: If constipation is contributing to incontinence, laxatives may be used to soften the stool and promote regular bowel movements. However, they should be used with caution and under medical supervision to avoid diarrhea.
Cholestyramine: This medication can help bind bile acids in the intestine, reducing diarrhea caused by bile acid malabsorption.
Fecal bulking agents A doctor can recommend appropriate medicine based on symptoms
Is Communicable
Bowel incontinence itself is not communicable. It is a symptom of an underlying medical condition or physical problem, not an infectious disease. However, certain underlying causes of bowel incontinence, such as infectious diarrhea, can be communicable.
Precautions
Dietary modifications: Avoid foods that trigger diarrhea or constipation. Increase fiber intake to promote regular bowel movements. Stay hydrated.
Bowel training: Establish a regular bowel movement schedule to help retrain the bowel.
Pelvic floor exercises (Kegel exercises): Strengthen the pelvic floor muscles to improve bowel control.
Maintain good hygiene: Clean the anal area thoroughly after each bowel movement. Use gentle, fragrance-free soaps and pat the area dry.
Protective garments: Wear absorbent pads or underwear to protect clothing and prevent skin irritation.
Skin care: Apply a barrier cream to protect the skin around the anus from moisture and irritation.
Medication management: Follow your doctor's instructions for taking medications to manage incontinence.
Avoid caffeine and alcohol: These can both increase bowel activity and worsen incontinence.
Consult a healthcare professional: Seek medical advice to determine the underlying cause of bowel incontinence and develop an appropriate treatment plan.
How long does an outbreak last?
The duration of bowel incontinence varies significantly depending on the underlying cause.
Acute causes (e.g., infectious diarrhea): Incontinence may last for a few days to a week until the infection resolves.
Chronic conditions (e.g., nerve damage, muscle damage): Incontinence can be ongoing and may require long-term management.
Temporary causes (e.g., medication side effect): Incontinence may resolve once the medication is stopped or adjusted.
How is it diagnosed?
Diagnosis of bowel incontinence typically involves:
Medical history and physical exam: The doctor will ask about your symptoms, bowel habits, medications, and medical history. A physical exam will include a rectal examination to assess anal sphincter muscle tone and rule out any structural abnormalities.
Stool tests: To check for infection or inflammation.
Anorectal manometry: Measures the strength of the anal sphincter muscles and the sensitivity of the rectum.
Rectal ultrasound: Provides images of the anal sphincter muscles to identify any damage.
Proctography (defecography): X-ray to view the rectum and anus during simulated defecation, assessing for structural problems.
Colonoscopy: Examination of the colon with a flexible tube and camera to look for abnormalities.
Nerve tests: To assess nerve function related to bowel control.
Timeline of Symptoms
The timeline of bowel incontinence symptoms is highly variable depending on the cause.
Sudden onset: May occur with acute diarrhea or injury.
Gradual onset: May develop slowly over time with nerve damage, muscle weakness, or constipation.
Intermittent: Symptoms may come and go, depending on factors such as diet, stress, or medication use.
Progressive: Symptoms may worsen over time if the underlying cause is not addressed.
Stable: Symptoms may remain relatively consistent over time with appropriate management.
Important Considerations
Seek medical advice promptly: Bowel incontinence can be a sign of an underlying medical condition that requires treatment.
Impact on quality of life: Bowel incontinence can significantly affect a person's quality of life, leading to embarrassment, social isolation, and anxiety.
Mental health: It is important to address the psychological impact of bowel incontinence. Consider seeking support from a therapist or counselor.
Multidisciplinary approach: Management of bowel incontinence often requires a multidisciplinary approach involving doctors, nurses, physical therapists, and dietitians.
Don't be afraid to discuss your symptoms with your doctor: Open communication is essential for effective diagnosis and treatment.
Self-management strategies: Dietary modifications, bowel training, and pelvic floor exercises can help improve bowel control.
Ongoing management: Bowel incontinence may require ongoing management and lifestyle adjustments to maintain bowel control and improve quality of life.