What Is Incontinence?
This refers to accidental loss of fecal material or stool. Some may have a more minor version of this problem whereby they only lose control of gas or small amounts of stool. Others may experience complete loss of control of bowel movements. Incontinence is more prevalent among women than men.
A significant problem affecting these individuals is the embarrassment and the stigma associated with incontinence which prevents them from seeking treatment even when incontinence affects their quality of life. Many people alter their physical and social activities or even employment in order to deal with their problems.
As providers, our biggest challenge is to encourage our patients to seek treatment and create an open and comfortable environment where patients can discuss these issues without shame or embarrassment.
What causes incontinence?
There are several causes of incontinence. Sometimes more than one cause may apply.
- Damage to anal sphincter muscle and nerves during childbirth
- Surgeries like hemorrhoidectomy, fistula treatment or removal of part of the colon.
- Medications like antibiotics and chronic laxative use
- Chemotherapy or radiation therapy
- Diet poor in fiber
- Diseases that cause chronic diarrhea
- Diseases that affect general health by diabetes and obesity
- Conditions that impair mental function like stroke.
- Spinal cord injury.
- Limited mobility and difficult access to a restroom.
How is incontinence diagnosed?
Typically, a thorough history and physical exam is good enough to get you started. Sometimes, additional testing may be required such as one of the following:
- Anal manometry: Study of pressures within the anal canal.
- Endoanal ultrasound: Ultrasound study of the anal sphincter.
- Flexible sigmoidoscopy, colonoscopy: Placement of a thin flexible camera tube to study the walls of the colon.
- Nerve studies: Check the normal functioning of the nerves that supply the anal canal.