Incontinence is the loss of control over the process of defecation caused by various disorders and injuries.
Causes of incontinence
The main cause of fecal incontinence is a breach in the functioning of the muscle sphincter and the inability to hold the contents of the colon.
The reflex apparatus must hold the contents of the intestine, which is liquid, solid and gaseous form. Cal held inside the rectum due to the interaction of the receptor apparatus and anal canal, which is carried out by a nerve, spinal cord and the muscular system.
The main causes of fecal incontinence have different aetiology and may be either congenital or acquired pathologies. These reasons include:
- anatomical pathology, including malformation of the anal machine defects of the rectum and the presence of a fistula in the anus;
- organic injuries after birth, brain injury;
- mental disorders, including neurosis, hysteria, psychosis, schizophrenia, etc .;
- presence of severe disease and complications from them (dementia, epilepsy, mania, etc.);
- traumatic injury closing apparatus, including operating trauma, injury, domestic and downs, tears of the rectum;
- acute infectious diseases, causing diarrhea and fecal impaction;
- neurological disorders caused due to diabetes, pelvic trauma, tumors of the anus, etc.
Types of incontinence
Fecal incontinence in adults and children of different etiology and mean anal inkontinentatsii. You can select the following types of incontinence:
- Regular fecal excretion without urgency to defecate;
- incontinence of stool in the urge to defecate;
- partial fecal incontinence during physical exertion, coughing, sneezing, etc .;
- age incontinence under the action of degenerative processes in the body.
Fecal incontinence in children in infancy is a normal condition in which a child has no ability to inhibit defecation and gases. If fecal incontinence in children lasts up to 3 years old, you should consult your doctor as you may have found a violation and pathology.
Fecal incontinence in adults is usually due to the presence of nervous and reflex pathology. Patients may appear anal failure, which is caused by a violation of the external sphincter and abnormal urinary content filled rectum.
In violation of the innervation of fecal incontinence in adults occur at the time of shutdown of consciousness, that is, during sleep, fainting and in stressful situations.
Receptor fecal incontinence in the elderly occur in the absence of urges to defecate, caused by lesions of the distal colon and central nervous system. Incontinence in the elderly is usually observed after incoordination, mental disorders and degenerative processes.
To assign the most correct treatment, necessary to accurately determine the type of incontinence - a congenital, post-natal, traumatic and functional.
In women, fecal incontinence can be caused by damage to the anal sphincter after childbirth. As a result of violations of the postpartum ruptures of the perineum and further abscess, which leads to the development of anal dysfunction machine.
Diagnosis of the disease
To determine an accurate diagnosis and to establish the right type of incontinence doctor assigns diagnostic tests and inspects for the presence of anatomical, neurological disorders and traumatic anal machine.
The therapist and the proctologist prescribed sensitivity study anus, sigmoidoscopy, ultrasound and magnetic resonance imaging.
Treatment of Fecal Incontinence
The first step in treating incontinence is to establish regular bowel movements and normal operation of the gastrointestinal tract. For the patient's prescribed diet is not only correct, but also regulate the diet corrected diet, its components and quantities.
After normalization of digestion prescribe drugs that suspend defecation, including furazolidone and Imodium.
The most effective treatment for fecal incontinence is the appointment of special training and exercises to strengthen the anal muscles. The program will allow the exercise to train the sphincter and restore the normal functioning of the anal machine.
For serious injuries anus and rectum prescribe surgery. A colostomy is an operation aimed at a compound of surgery of the colon and abdominal wall. Anal extending fully crosslinked, and the patient after the operation can be performed only in the defecation special removable bag which is attached to the abdominal wall. Such an operation is carried out only in extreme cases.
Conservative treatment of fecal incontinence involves performing medical therapy, electrical stimulation and therapeutic exercises. Electrical stimulation of the perineum and bagasse aims to improve the contractile function of the anal muscles, restoring the ability of the obturator of the rectum and anus strengthening. Medications as part of basic therapy will improve the nervous excitability in synapses and normalize the muscle tissue. The drug is prescribed, depending on the diagnostic indications and the patient's condition, the type of incontinence and the stage of the disease.
If necessary, designate the combined treatment of fecal incontinence, which is carried out at the surgical removal of hemorrhoids and restore the rectum.
As an additional therapy may be prescribed a course of water treatment and Biofeedback, which is aimed at training the anal muscles using a special device and diagnostic monitor.