Fecal incontinence in older people treated with folk remedies. What to do if you have fecal incontinence Involuntary loss of feces

Fecal incontinence is not only a medical, but also a social problem that significantly impairs a person’s quality of life. The symptom occurs in diseases of the gastrointestinal tract, pathology of the nervous system, mental disorders, and complicated childbirth. Conservative and surgical methods are used for treatment.

Diseases for which the characteristic symptom is:

• haemorrhoids;
• nonspecific ulcerative colitis;
• Crohn's disease;
• schizophrenia;
• senile dementia;
• stroke;
• tumors and spinal cord injuries.

Defecation - principle of operation

The intestine consists of two sections: the small and large intestine. The duodenum, jejunum and ileum are parts of the small intestine. This department is responsible for digesting food. The large intestine consists of the cecum, colon and rectum. This is where water is absorbed and feces are formed.

The crushed food enters the stomach, where it begins to be digested under the influence of enzymes and hydrochloric acid. Chyme (partially digested food) enters the duodenum, where the ducts of the gallbladder and pancreas open. Nutrients are absorbed in the small intestine using villi. The chyme moves towards the large intestine and moisture is absorbed. The formed feces presses on the rectum, relaxes the sphincters and the person feels the desire to defecate.

The normal frequency of bowel movements is from 1-3 times a day to 3 times a week. The act of defecation is painless and does not cause any discomfort.

Encopresis: general characteristics

Fecal incontinence is the medical term for encopresis. It refers to the inability to control bowel movements. A person cannot delay the excretion of feces until it becomes possible to visit the toilet for this purpose. This also includes the release of solid or liquid feces during the passage of gases. More than 70% of encopresis cases occur in children under 5 years of age. Fecal incontinence is often preceded by constipation. The symptom also occurs in people over 50 years of age. It leads to social isolation along with diseases such as dementia and Alzheimer's disease.

Fecal incontinence is a social problem (photo: www.mojdoktor.pro)

Kinds

Depending on the causative factor, there are four types of encopresis:

• regular excretion of feces without the urge to defecate;
• fecal incontinence with the urge to pass bowel movements;
• partial fecal incontinence during exercise, coughing, laughing, sneezing;
• age-related encopresis under the influence of degenerative processes in the body.

It is also worth noting what types of fecal incontinence there are:

• functional;
• postpartum;
• congenital;
• traumatic.

To prescribe the correct treatment, you must determine the classification and origin of the pathology.

Development mechanism

Encopresis is associated with dysregulation of centers that are responsible for the formation of conditioned reflexes. There are three mechanisms that contribute to the appearance of the symptom:

• the absence of mechanisms responsible for the appearance of a conditioned reflex of the act of defecation. This pathology is congenital. The person does not have a rectoanal inhibitory reflex, which stimulates bowel movements;
• delayed formation of a conditioned reflex;
• loss of reflex, which arose due to unfavorable factors.

There are two development options: primary and secondary. In the first case, the pathology is considered congenital. Secondary incontinence occurs after a disturbance in the patient’s mental state, injury, damage to the nervous or excretory system.

Causes

The main cause of fecal incontinence is a violation of nervous regulation and weakness of the anal sphincter. Normally, the muscular apparatus of the small intestine should hold feces of any consistency.

The causes of encopresis are congenital and acquired:

• anatomical defects in the development of the anal apparatus;
• organic pathologies that can occur after childbirth and brain injuries;
• mental illness (neurosis, schizophrenia, hysteria);
• constipation;
• diarrhea;
• muscle weakness, decreased tone;
• dysfunctional pelvic floor disorders;
• haemorrhoids.

Constipation is a condition in which the number of bowel movements does not exceed three in one week. This leads to the fact that part of the solid feces is retained in the intestines. At the same time, some liquid stool may also accumulate and leak through the hard stool. If constipation lasts for a long time, this will be a consequence of overstretching of the muscular layer of the rectum and anal sphincter, which will lead to fecal incontinence.

Diarrhea can also cause fecal incontinence. This is explained by the fact that the accumulation of liquid stool occurs much faster and the pressure on the rectum is greater. The body cannot restrain the urge to defecate, which leads to incontinence.

Muscle weakness of the sphincters. Occurs when nervous regulation is disrupted. It is also common in the postpartum period, when some women experience a perineal tear. The same applies to people who have undergone surgery on the intestines.

Doctor's advice! When the first signs of fecal incontinence appear, do not engage in self-diagnosis or treatment with folk remedies. Seek medical help immediately

As a result of certain diseases (Crohn's disease, ulcerative colitis), scars and ulcers form on the intestinal mucosa. This prevents normal contraction of the muscle layer of the intestine, peristalsis weakens, and tone decreases. Such conditions can provoke fecal incontinence.

Dysfunctional pelvic floor disorders are associated with improper functioning of the nervous system. This happens when the sensitivity of the perineum is impaired, the pelvic floor relaxes with a tendency for the pelvic diaphragm to sag. Often occurs after childbirth and episiotomy (surgical incision in the perineum).

Risk factors

Risk factors include the presence of chronic diseases of the lower large intestine. People with pelvic floor muscle weakness are at increased risk. Also people who have undergone operations on the gastrointestinal tract, young mothers with a perineal rupture.

Clinical picture

The clinical picture of fecal incontinence is that the act of defecation occurs involuntarily. That is, a person cannot prepare for bowel movements and does not have time to visit the toilet for this purpose. Some people experience involuntary bowel movements when they sneeze, cough, laugh, or exercise. Some people suffer from fecal incontinence without the urge to defecate, while others have the urge. The circumstances under which defecation occurs vary and depend on the cause of the symptom.

Associated symptoms for various diseases

In inflammatory bowel diseases, in addition to fecal incontinence, the main symptoms include pain in the lower abdomen, increased body temperature (38-39º C), weight loss, weakness, fatigue, and false urge to defecate.

Hemorrhoids are characterized by constant pain in the anal area, gaping of the rectum, bleeding, burning sensation and itching. Patients complain of pain in the anus when walking, sneezing, coughing, sitting, and the appearance of hemorrhoids, which increase with straining.

In mental illnesses, the main symptoms come first in the form of hallucinations, illusions, and cognitive impairment.

As for Alzheimer's disease, it is characterized by memory loss, speech impairment, and deterioration of reading and speaking skills. The patient is not able to cope with everyday skills, so he needs the help of family and friends.

Incontinence in children

In children under four years of age, fecal and urinary incontinence is normal. This is explained by the fact that everyday habits are just being formed and the child is learning these skills. As for older children, they are more likely to experience incontinence due to frequent constipation.

Encopresis in children can also be primary and secondary. In primary cases, the child lacks skills regarding the act of defecation. Secondary occurs against the background of stress, illness, overexertion. Moreover, these children had no previous problems with bowel movements.

A common cause of encopresis in children is the strong desire of the parents to teach the child to go potty. Thus, a stressful situation is formed for the baby and he reacts accordingly. Therefore, parents must approach the issue of education with all seriousness, without causing harm to the child.

Incontinence in women during pregnancy and after childbirth

During pregnancy, namely after the 34th week, fecal incontinence occurs in 5 percent of women. This is due to the pressure of the uterus on the rectum and bladder. After delivery, factors affecting fecal incontinence are:

• first birth;
• delivery using obstetric forceps or a vacuum extractor;
• prolonged second stage of labor;
• fetal weight is more than 4 kilograms;
• polyhydramnios;
• multiple births;
• median episiotomy (dissection of the perineum along the midline);
• posterior view of occipital presentation;
• previous anal sphincter rupture.

Among women who delivered with forceps, fecal incontinence occurs in 16%. When using a vacuum extractor, the figure is slightly lower, only 7 percent.

Incontinence in the elderly

In older people (over 60 years old), fecal incontinence is a secondary process. The symptom is often associated with a pathology of the nervous system, namely a disruption of the cortical defecation center. If there are problems with the functioning of the anal sphincter, involuntary bowel movements can occur up to six times a day.

Encopresis in older people is associated with mental disorders and degenerative brain diseases. A person loses cognitive skills (reading, memory, speech). Along with this, adaptation to the environment deteriorates; he is unable to care for himself on his own and requires outside help.

Which doctor and when to contact

At the first signs of incontinence, you should contact either. The doctor will collect anamnesis, prescribe additional research methods and choose further treatment tactics. He will either do the treatment himself or refer you to.

Diagnostics

Diagnosis of incontinence includes a detailed medical history. The doctor finds out the frequency of involuntary bowel movements, the amount of discharge, its color, consistency, etc. It is also important to determine whether there is a urge before bowel movements.

• anorectal manometry. This diagnostic method is aimed at determining the pressure in the anal sphincter;
• transrectal ultrasound examination. Using the method, you can visualize the structural structure of the anal muscles;
• defectography (proctography) - an x-ray examination that shows the amount of feces in the intestines;
• sigmoidoscopy is an endoscopic method showing the condition of the intestinal mucosa.

Diagnostics will provide a complete picture of the origin of the disease. This will help you choose the most appropriate treatment strategy.

Treatment

Treatment of fecal incontinence is divided into two groups: conservative and surgical. Conservative treatment can be non-medicinal and medicinal.

Non-drug treatments include:

• diet therapy;
• physical exercise;
• electrical stimulation;
• acupuncture;
• psychotherapy.

Electrical stimulation is carried out with the aim of irritating nerve endings, which leads to the formation of a conditioned reflex responsible for the act of defecation.

Acupuncture is used in cases where patients experience increased excitability. Manipulation helps to relax a person.

Psychotherapy is used in patients whose cause of encopresis is mental disorders or traumatic diseases of the nervous system.

The most commonly used medications are:

• strychnine;
• proserin;
• B vitamins;

Medicines are prescribed for functional diseases of the gastrointestinal tract. They are aimed both at combating the underlying disease and relieving symptoms.

Surgical treatment is used in cases where the cause of the symptom is injury to the anal sphincter. Plastic surgeries are often used in proctology.

The type of surgery depends on the degree of damage to the anus. If the defect is observed in less than a quarter of the sphincter (in diameter), an operation called sphincteroplasty is used. If the damage is more massive, the operation is called sphincterogluteoplasty. The name reflects the essence of the intervention: part of the gluteal muscle is used as a material for plastic surgery.

Important! Fecal incontinence (encopresis) is a symptom characterized by the involuntary release of feces. Occurs due to diseases of the gastrointestinal tract, nervous system, and perineal trauma. Treatment uses diet, medications, and surgery. To prevent the symptom, strengthen the pelvic floor muscles and follow a diet

Diet food

Diet plays a leading role in the treatment of fecal incontinence. Sometimes changing your eating habits is enough to get rid of the symptom. Basic nutritional recommendations:

• eat more protein foods and fiber. These components improve the quality of digestion, creating stool with a soft consistency. Fiber is found in bran, almonds, flax, mushrooms, apricots, and wheat. The daily norm is from 20 to 30 grams. It should be introduced gradually, as excessive amounts can lead to increased gas formation;
• drinking plenty of fluids. The daily intake of water is 30 ml per 10 kg of body weight. It is better to drink water than other liquids (tea, coffee, juices). Since water does not contain additional calories and does not interfere with the normal formation of feces;
• Based on the results of the blood test, vitamins and nutritional supplements may be prescribed.

The consumption of dairy products, smoked meats, sweeteners, caffeine, spicy and salty foods should be avoided.

Exercises

To get rid of this unpleasant symptom, doctors recommend using exercises aimed at strengthening the pelvic floor muscles. Kegel exercises help increase blood circulation and improve muscle tone. The complex consists of three parts:

• slow contractions. The pelvic floor muscles are tensed, counted to 3, then relaxed;
• fast contractions. Muscles tense and relax as quickly as possible;
• pushing out Women need to push moderately, as during childbirth. For men - as during the release of urine or the act of defecation.

The good thing about exercises is that they can be performed anywhere and at any time of the day, since they do not require additional devices. To achieve the effect, up to 5 repetitions per day are required.

Consequences and complications

People suffering from the symptom try to lead an isolated lifestyle, as they feel psychological and physical discomfort in society. This leads to the person being susceptible to dysphoria and depression. And treating depression is a long and expensive undertaking.

Complications from the anal canal include the addition of secondary bacterial flora, as well as the appearance of cracks.

The main advice is to consult a doctor in a timely manner. The earlier treatment is started, the better and more favorable the prognosis will be.

People suffering from fecal incontinence experience discomfort in society because of their problem. When leaving home, you should follow several rules:

• take with you the necessary hygiene materials (napkins, clean linen, a change of clothes);
• be sure to visit the toilet before leaving;
• In public places, find the toilet before you need it.

These simple tips will help you feel more confident in the company of people.

Forecast

When encopresis is caused by diseases of the gastrointestinal tract, the prognosis for recovery, performance and life is favorable. This is possible with an integrated approach to treatment: diet, medication and physical activity.

If the cause of encopresis is mental disorders and organic diseases of the nervous system, the prognosis, alas, is unfavorable.

Prevention

Preventing fecal incontinence is easier than treating the symptom. To prevent the occurrence of encopresis, adhere to the following rules:

• treatment of chronic diseases of the gastrointestinal tract;
• rational and nutritious diet high in protein and fiber;
• avoiding anal sex;
• timely bowel movement. You should not tolerate or delay the act of defecation;
• training the pelvic floor muscles by squeezing and relaxing the perineal muscles.

The symptom of encopresis is sensitive and unpleasant. It brings discomfort not only to the sick person, but also to those around him. It’s easier to do prevention than to spend a lot of effort and money on treatment.

Problems with stool often worry people who are bedridden due to serious illnesses. This category of patients is especially vulnerable to disorders of the digestive tract. The danger lies in many aspects, for example, loss of large amounts of body fluid with feces, impaired absorption of nutrients from food, skin infection and bedsores. It is worth solving such a problem as soon as it begins, as this can greatly complicate the already difficult life of a bedridden patient.

What can cause fecal incontinence?

Scientists identify two main categories of reasons due to which the violation occurs. For each patient, the speed of development and severity of the process occurs individually, depending on the underlying cause:

1. Psychogenic factor. Includes mental illnesses and disorders. Against the background of severe psychosis, schizophrenia, and even when the integrity of the individual is violated, the functioning of some body systems, in particular the gastrointestinal tract, is disrupted. There are cases when a bedridden patient passes feces constantly, without interruption, and the reason for this, for example, is the onset of psychosis;
2. Physiological disorders. They include weakening of the sphincter and muscles of the rectum, infection with pathogenic bacteria, accumulation of large amounts of hard feces (fecal impaction), indigestion after surgery or in the presence of tumors in the intestines, as well as internal bleeding.

It is important to establish the exact reason why fecal incontinence occurs in a bedridden patient. A detailed history collection from relatives and a conversation with the patient himself is a very important step for diagnosis. Obvious causes do not always allow for an accurate diagnosis.

Important! Intestinal bleeding greatly changes the color and smell of stool. The consistency is not uniform, blood clots may be present, and the smell is sharp and foul. The discharge always changes color to black, and if black feces are noticed in a bedridden patient, you should immediately seek help.

For example, when talking with a patient, the doctor understands that there is a clear clinical picture of acute psychosis or delirium. At the same time, it is important to make sure that the patient does not have intestinal bleeding, due to which a large amount of blood is lost, which disrupts the delivery of oxygen to the human brain - hence, a bedridden patient may develop clouding of mind.

Features of feces formation in bedridden patients

The less a person moves, the weaker intestinal motility occurs. It is no secret to many that bedridden patients often develop constipation and this happens because the human diet contains a large amount of dietary fiber and lacks fluid. This leads to the formation of dense feces that do not leave the intestines and form a fecal blockage.

In turn, the presence of such feces prevents the already weakened intestinal motility from absorbing nutrients from food and forming new feces. This leads to the formation of large amounts of liquid stool, which constantly oozes from the rectum.

Important! The peculiarity of therapy for bedridden patients is to follow a strict diet prescribed by the doctor. A common occurrence in bedridden patients with a hip fracture is fecal incontinence. Therefore, it is important not to deviate from the prescribed diet, so as not to aggravate the person’s condition.

When fecal incontinence is detected in a person, there is no need to ask the question “why does a bedridden patient constantly leak feces.” It is important to immediately contact specialists for diagnostic measures in order to eliminate the cause of the disorder as soon as possible and normalize intestinal function. The symptoms that may accompany fecal incontinence in a bedridden patient are quite extensive and do not always appear. Therefore, you need to carefully monitor the person’s condition.

There are often cases when relatives independently prescribe drugs for diarrhea to a bedridden patient, because they believe that the cause of fecal incontinence is stale food and, as a rule, taking the drugs does not give any effect. What is important is one of the important symptoms of indigestion - severe bloating and intense peristalsis with fecal incontinence are absent. Therefore, you need to be careful about the symptomatic picture.

What to do if a bedridden patient has fecal incontinence

The most important and important step is to see a doctor. If a bedridden patient is in a hospital, then the attention of medical personnel should be drawn to the problem that has arisen. If a person is unable to move independently, then it is best to lay him on his side and place a disposable absorbent diaper under the pelvis.

You should not place a person on a bedpan for a long time, as frequent contact and friction with a hard surface provokes the development of bedsores. Despite the fact that it is not advisable to use a vessel, there is a special vessel for bedridden patients, for feces that do not have a formalized condition. The surface of such a vessel is softer and partially takes the shape of the human pelvis, which reduces pressure on the sacrum, and the material from which the product is made does not injure the skin during installation of the vessel.

It is important to understand that only the attending physician can prescribe drug therapy and therefore you should not independently give drugs to a bedridden patient. After all, without knowing the exact cause of fecal incontinence, one cannot “guess” what drug could help. This can only harm a person.

If the patient is able to move on his own, you can use a bedside toilet, which is quite convenient to use, since the person does not need to walk far and lose strength. Often bedridden patients begin to get nervous and upset, as they are unable to influence the process. It is important to be there and explain that it is not his fault. Fecal incontinence in a bedridden patient greatly exhausts the person and therefore psychological comfort must be maintained.

Video

If stool and gas production gets out of control, it can become a serious problem.

There are diseases and disorders that we are ashamed of, and the presence of which we try not to tell others about. Among the “shameful” disorders of our body there are those that even the usual presence in public makes a reason for fear and anxiety. Fecal and gas incontinence, or anal incontinence, is one such disorder.

Incontinence of feces and gases, forms and varieties

Fecal and gas incontinence is the inability to control the action of the anal sphincter. According to the degree of weakening of control over this process, three stages are distinguished:

• Loss of control over the gas separation process.
• Incontinence of gases and liquid feces.
• Incontinence of gases, liquid and solid feces is the most severe form of loss of control over the process of the sphincter.

In this case, a person may or may not feel that he is having a bowel movement. In the first case, fecal leakage can occur when a person feels the urge to defecate, but cannot control this process. In the second, when fecal leakage occurs spontaneously and the person does not feel any urge.

Fecal and gas incontinence is normal for infants. But by the age of three, the child must learn to control these processes. If anal incontinence is observed in adults, this is a serious problem. Fecal and gas incontinence often occurs in old age, but can appear much earlier.

Causes of inoperability of the anal sphincter

The reasons for the development of this phenomenon can be very different; both anatomical defects and physiological disorders can lead to incontinence. Among the causes of fecal and gas incontinence:

• Anatomical problems. For example, fistulas in the anus and anal fissures can cause problems with the sphincter.
• Organic causes. Damage to the brain or spinal cord, postoperative and postpartum injuries.
• Psychogenic factors: neuroses, psychoses, hysteria .

Fecal and gas incontinence can be a manifestation of certain diseases. Uncontrolled bowel movements can result from catatonic syndrome, manic-depressive syndrome, dementia, and epilepsy.

Treatment of fecal and gas incontinence

To treat this disorder, you need to understand the causes of its occurrence and, based on this, adjust the treatment. It is also important how much control over the work of the anal sphincter is lost.

For the treatment of fecal and gas incontinence, the following is used:

• therapeutic exercises and water procedures
• diet
• surgical intervention

Physiotherapy

This is a very important part of treatment , aimed at training the anal sphincter muscles. There are many different techniques . For example, you can simply try to squeeze and unclench your sphincter several times a day for a few minutes.

Sphincter training using the biofeedback method is quite common. In this case, a special device is inserted into the anus - a balloon filled with air. The patient tries to make an effort and squeeze the sphincter. This creates pressure on the balloon. Data on how strongly the anal sphincter contracts is displayed on a special monitor connected to the balloon.

Another option for restoring the functions of the anal sphincter is to irritate it with an electric current.

Diet

In some cases, stool leakage occurs only with diarrhea. In this case, first of all you need to pay attention to your diet. It is necessary to exclude foods that provoke from the menu.

In addition, people suffering from fecal and gas incontinence are advised to eat more protein and dietary fiber.

Surgical intervention

The cause of urinary incontinence in men may be the constant consumption of caffeine, a new study conducted by American urologists has shown.

If the above methods are ineffective, surgery is recommended. The operation is performed only in stationary conditions. The essence of the intervention is to sutured the non-functioning sphincter. The nature of the surgical intervention depends on the severity of the damage to the sphincter and on which parts of the muscular structure of the anal sphincter are deformed.

For minor damage, sphincteroplasty is used, and for more extensive damage, sphincterolevatoroplasty is used. With sphincteroplasty, a gentle excision of the defect is performed, after which two or three catgut sutures are made. When performing sphincterolevatoplasty, a more extensive surgical intervention is performed, during which the sphincter muscles are sutured, part of the rectal wall is corrugated, and thus the correct shape of the anal canal is formed.

The choice of the type of surgical intervention is made by the doctor based on data on the state of the anal sphincter, the state of the nervous system and other important health indicators.

If the process of releasing gases and feces has become uncontrollable, this is a rather serious violation and it will take a lot of time to restore the functioning of the sphincter. Be patient, tune in to a positive result and follow all the doctor’s recommendations - this will help you cope with the problem.

Fecal incontinence or, as this disease is called in medical language, encopresis is a violation of the control of bowel movements. In most cases, when they talk about such a pathology, they mean children, but it also occurs in adults and is usually associated with serious diseases of an organic nature.

Lack of bowel control means that a person is unable to hold in stool until going to the bathroom. Also known as encopresis is the involuntary release of part of the stool during physical tension in the abdominal cavity.

If we talk about stool incontinence in adults, the pathology is often almost 1.5 times diagnosed in males. In addition, there is an opinion that this disease is a physiological sign of aging. However, the statement is completely untrue, since the risk group is middle-aged people, that is, from 40 to 60 years old. Encopresis is related to old age in the sense that patients are almost completely isolated from society. In younger patients, there is a significant deterioration in the quality of life, psychological problems arise associated with complexes, the inability to have a sexual life, and so on.

In order to understand the causes of fecal incontinence in men and women, as well as in the treatment of this nosology, one should understand how the process of defecation normally occurs. This physiological process is controlled by the nerves of the rectum and anus, as well as the muscular apparatus of these same structures. Management consists not only in retention of stool in the intestines, but also in the formation of urge and release of feces.

When stool enters the distal rectum, the external and external sphincters are tightly compressed. The chair at this time is already fully decorated. Also, the pelvic floor muscles play a role in retaining feces in the intestines until the urge forms.

The sphincter itself consists of an outer and an outer section. Pressure when exerted can vary from 50 to 120 mm Hg. Art. In males it is usually higher than in females. With age, pressure in the anal sphincter area decreases, but the process does not become the direct cause of the pathology unless there are any additional factors. A special feature of the sphincter is that it is in a certain tone at any time. The internal part of this organ is innervated by the autonomic nervous system, which means it is not subject to human conscious control. The external department, on the contrary, obeys arbitrary commands.

Feces remain in the rectum until the urge to defecate is formed, for which the mechanical receptors of the rectum are responsible. They are irritated by the accumulation of feces in the intestine and stretching of its walls. After the urge is formed, a person needs to take a sitting position (or squatting). Contraction of the abdominal muscles together with a closed glottis forms a reflex, due to which intra-abdominal pressure increases. All the muscles that hold back the stool relax, and the irritated nerves of the rectum transmit the command to the sphincter to open, allowing the stool to come out.

If, when the urge is formed, it is not possible to defecate, then the voluntarily contracted muscles of the external sphincter hold the feces inside the rectum. At the same time, the rectum itself expands, which is why the urge gradually disappears for some time.

Etiology of the disease

The causes of fecal incontinence in adults differ from those in children, since incontinence in them develops as a secondary pathology. The main etiological factors causing an undesirable complication:

1. Diarrhea. The phenomenon of diarrhea is the most harmless cause of fecal incontinence. Due to the fact that the stool acquires a liquid consistency, it is much more difficult to keep it in the rectal ampoule than formed feces. Diarrhea is a temporary factor in encopresis, as control is restored when it subsides.
2. Constipation. Due to the fact that large amounts of solid feces accumulate in the intestine, it stretches and the sphincter weakens. In this regard, the urge to defecate is weakly formed, and the anus relaxes, allowing feces to pass through. Another option for releasing stool during constipation is possible: liquid stool accumulates over hardened stool and, seeping through it, flows out of the anus.
3. Injuries to the muscular system or weakness of their tone. Damage to the sphincter muscles can occur as a result of domestic injuries or surgical interventions. The most common occurrence of fecal incontinence is after hemorrhoid surgery.
4. Problems with innervation. There are two options for disruption of impulse conduction. In the first case, the problem lies in the nerve endings of both parts of the sphincters, when it cannot contract or relax normally. The second option is based on problems in the brain or on the way to it, when a person does not feel the urge to defecate, so cannot prevent it.
5. Scarring of the rectum. The condition is characterized by a decrease in the elasticity of the intestinal walls, which is why encopresis develops. The reasons leading to the appearance of scars are most often inflammatory processes in the rectum, operations on the intestine, and radiation exposure during radiation therapy.
6. Dilatation of hemorrhoidal veins. The nodes formed during the disease prevent the closure of the muscular apparatus of the anus.
7. Problems with the pelvic muscles. This etiology includes, for example, fecal incontinence after childbirth, when a significant decrease in the strength of the pelvic floor muscles can occur. Incontinence is most likely to occur after a pathological birth with a rupture or surgical incision of the perineum.

Diagnostics

The symptom of fecal incontinence allows one to immediately diagnose the nosology, but it is important to determine the etiological factor that caused it. Therefore, such patients are prescribed a number of studies:

• Survey. It may be a subjective study, but in this case it allows one to more or less determine the cause of the pathology and refer the patient to the appropriate specialist.
• Anorectal manometry. It is carried out to determine the level of sensitivity of the rectum, assess the strength of compression of the sphincter muscles and its innervation.
• MRI. Allows you to take accurate photographs of the muscular apparatus of the anus.
• Transrectal ultrasound. It is carried out to assess the structure of the muscular system. The procedure is invasive, but absolutely safe.
• Proctography. The method is X-ray and shows the rectum while feces are in it. It is determined how much chair she can hold, how it is distributed and other details.
• . A study for visual assessment of the walls of the rectum, which is especially important if scarring is suspected or to exclude a tumor process.
• Electromyography. Allows you to assess the condition of the neuromuscular apparatus of the pelvic floor.

After determining the exact etiology of the disease, a treatment plan is drawn up, which may consist of one or more types of therapy.

Treatment

Since fecal incontinence should be treated according to the cause of the disease, there are many treatment options.

• Diet

The diet for fecal incontinence should always be changed, however, as the main method of treatment it is used only for constipation or diarrhea. Basic recommendations for eating during encopresis:

1. You should consume increased amounts of foods containing fiber. This helps normalize the consistency and manageability of stool and prevents the formation of constipation. However, it is necessary to increase its content in the diet carefully, as excessive accumulation of gases may occur.
2. Preferably drink large amounts of water. Precisely pure water, and not drinks containing it. In addition, you should drink juices with caution, as some of them can cause diarrhea.
3. It is recommended to write down foods that in any way affect stool consistency so that they can be consumed with caution or eliminated from the diet altogether.
4. In old age, folk remedies that help soften stool, for example, drinking petroleum jelly in certain quantities, will be useful.

The exact diet is determined individually depending on the body’s tolerance to certain foods.

• Conservative

Drug treatment is also highly effective only in cases of bowel dysfunction. Laxatives or antidiarrheal drugs are used. The latter significantly slow down the functioning of the intestines, so that feces have time to form. It is also possible to use drugs that help reduce the amount of water in stool.

Conservative therapy also includes non-drug options for getting rid of the problem:

1. Mode. For constipation or absence of the urge to defecate, the optimal way to improve the condition is to introduce a bowel movement routine. You should set your body a certain rhythm that it will follow, for example, defecation after each meal or after a certain period of time.
2. Exercises. Special gymnastics for the muscular system of the pelvic floor is successful, for example, if the problem developed after childbirth. If incontinence is caused by a lack of innervation, then no exercise will help.

• Surgical

If previous treatment methods are inappropriate or ineffective, the possibility of surgical intervention is considered. Surgery can be of several types, and the choice depends on the etiology of the pathology and, most often, the age of the patient and the presence of concomitant diseases. Methods that are used:

1. Straight sphincter. It consists of strengthening the muscles of the anus by connecting them more firmly to the rectum. Used for damage to the sphincter muscles due to any damage or physiological atrophy.
2. Artificial sphincter. It is installed around the present and is a connection of a special cuff, a pressure regulator and a pump.
3. . The operation involves connecting a section of the large intestine to the anterior abdominal wall, where defecation will occur in a special bag. Often used for tumor lesions and inflammatory processes of the rectum.

• Electrical stimulation

The procedure is relatively new and involves electrical stimulation of the pudendal nerve. Moreover, stimulation occurs constantly using a special device that is installed under the skin. It runs on batteries. The procedure is advisable if there is a violation of the innervation of the rectum and sphincters, but it will not help if the problem is formed at higher levels, that is, in the brain or spinal cord.