Fecal Incontinence

Stool incontinence means it leaks poop without you being able to prevent it. The fact that it is delicious may be due to different things. There is a lot you can do yourself to relieve, but sometimes an operation may be needed. Having stool incontinence is more common than many people think.

This text is about stool incontinence in adults. If you want to read about this in children, you can do so in the article Children who are peeing.

The stool is another word for poop. The word feces is often used in health care.

Different types of stool incontinence

You may have temporary problems of stool incontinence, or more prolonged.

The degree of stool incontinence can be different. It may be that you have difficulty holding gases, or that it will leak fluid if you have loose stools. It may also be that you cannot resist when you feel the need to poop. One form of incontinence is that you do not notice it leaking.

The bag that leaks may be loose or solid. Sometimes it can leak both loose and solid poop at the same time.

The skin around the rectum can become red, itchy and stingy. 

When and where should I seek care?

Contact a health care center if you have trouble with stool incontinence. You can contact many receptions by logging in.

Investigations

When you come to a doctor you will be told about your complaints. Sometimes you can fill out a questionnaire. You can then answer the following questions:

  • Is the poop loose or hard?
  • How much is it delicious?
  • How often does it leak?
  • How does it affect your everyday life and quality of life?

The doctor then examines the rectum, usually with both a finger and a rectoscope.

Sometimes the doctor may also want the colon to be examined. You are then examined with a colonoscopy. You will receive a referral to the survey.

More investigations

Sometimes more studies may be needed, such as the following:

  • Analog pressure measurement is used to check the function of the end muscles.
  • Electromyography can examine the function of the nerves in the rectum. Electromyography is often shortened to EMG.
  • Ultrasound allows the doctor to see if there is any damage to the muscles of the rectum.
  • The X-ray makes it possible to examine the pinch function and what happens in the pelvic floor and rectum when you pinch or squeeze. Cross-X-ray is also called defecography.
  • Magnetic cameras can sometimes be used instead of X-rays. The magnetic camera is used to see what the pelvis looks like and to find out the cause of the stool incontinence.

What is it?

The rectum is the last part of the gastrointestinal tract and acts as a container where the stools can be stored until you go to the toilet.

The rectum has two muscles that make the stools stay in the rectum, the inner ring muscle, and the outer ring muscle. Together they are called the end muscles. Only the outer ring muscle can be controlled with the will. It is the one you struggle with when you refrain from pooping.

The work of the rectum is dependent on the nerve connections to function properly. The nerves go from the brain, through the spinal cord and out to the muscles of the rectum. Some reflexes are controlled directly from the spinal cord without the involvement of the brain.

Age

As you get older it can be harder to keep tight. This is because the end muscles of the rectum are weakened. The nerves to the rectum also work worse.

Damage to the end muscles

In connection with a birth, the end muscles can be damaged, so-called sphincter rupture. The nerves can also be damaged so that their function becomes worse.

Other causes that can damage the end muscles may be that something has been inserted with force in the rectum, for example during sex or in connection with a sexual assault.

Operations

You may suffer damage to the end muscles if you are operating in or near them. For example, you may have had one of the following:

  • Bulbs or fistulas. A fistula is a small duct formed between, for example, the rectum and the skin around the rectum.
  • Fissures. A fissure is a crack in the skin of the rectum that often hurts a lot.
  • Hemorrhoids.
  • Cancer tumor in the rectum.

Diseases

Stomach illness with vomiting and diarrhea can cause you to have temporary trouble keeping tight. It goes over when you have recovered from the stomach ailment.

Diseases of the intestines can cause diarrhea, such as the inflammatory bowel diseases of ulcerative colitisCrohn’s disease, and microscopic colitis. Even tumors or other growths can cause diarrhea and fecal incontinence.

Diseases and injuries to the nerves, spinal cord or brain can affect the nerves so that the nerve connections to the end muscles do not work properly. For example, it can happen under the following conditions:

  • Stroke.
  • Various dementia diseases such as  Alzheimer’s disease.
  • Disk hernias.
  • Spine Fractures.

Another condition that can lead to stool incontinence is rectal incidence. This is when the lower part of the rectum comes out through the rectum opening, for example, when you squeeze or lift something heavy.

Radiation therapy in cancer disease

Stool incontinence can be a result of getting radiation treatment to the pelvis. The radiation causes inflammation of the rectum, but it also affects the nerves, the end muscles, and the intestinal wall.

Examples of cancers treated with radiation therapy to the pelvis are as follows:

  • Prostate cancer.
  • Cancer of the genital area, such as cervical or cervical cancer.
  • Colon cancer.

What can I do for myself?

You can do some yourself to improve the hassles. It can sometimes take a few weeks to get better.

Eat a varied diet

Try to eat regular and high-fiber and healthy foods. Talk to a dietitian if you are unsure of what to eat. 

Drinking too much alcohol for an extended period of time can damage nerve tissues and thus worsen stool incontinence. Talk to your doctor if you want to change your alcohol habits.

You can try using the so-called bulk agent to make the buoy firmer. You need to drink more fluid when using bulk agents, in order for it to work properly. Examples of bulk agents are Vi-Siblin, Lunelax, and Inolaxol.

Eat less of some food

Eat less or avoid eating foods that make the poo lose. For example, it could be any of the following:

  • Fiber-rich and soluble food like prunes.
  • Gas-forming foods such as onions, cabbage, peas, and beans.

Also, eat less fatty food as it makes the poo lose.

Some foods can increase the amount of gas in the digestive tract. Eat less of such food if you have problems with gases in your stomach.

Try to poop regularly

Pawing regularly can reduce the risk of paw leaks. For example, you may try to poop properly in the morning to clear the bowel.

Baze when you need it. Often, a reflex will poop after eating. Then try to go to the toilet and not hold back. Don’t stress either, but take the time you need.

Use laxatives or enamels

Sometimes it may be easier to empty the rectum if you use laxatives or enema. Talk to your doctor first before using laxatives or enema.

Emptying the bowel with enema regularly is called intestinal flushing or irrigation. It can also relieve.

Medicines for diarrhea can help

Medicines containing active substance loperamide can sometimes reduce leakage. Use this medicine only when you do not have access to a toilet. The drug can sometimes be used regularly, but only if your doctor has recommended it.

Exercise

Try to find a form of exercise that works for you and that makes you feel good. Exercise stimulates the work of the intestines and drives the intestinal contents. This makes the bowel easier to clear.

Some may avoid exercising as it may leak more feces during exercise. Adapt your workout to what you feel is good.

Exercise the muscles of the rectum

You can train your rectal muscles with pelvic floor training.

You should talk to your doctor or midwife when you can begin pelvic floor training if you have had bowel incontinence after surgery or delivery.

Relieve irritated skin around the rectum

Use a block of mild soap without perfume when washing your buttocks. Do not wash too often as it may increase skin irritation.

You can also lubricate the skin around the rectum opening after washing. Use an oily or skin-protecting ointment.

Use soft toilet paper and pat dry when drying in the buttocks.

Review your medicines

Many drugs affect intestinal function. Talk to your doctor if you are unsure if your medication is affecting. You can also ask the staff of a pharmacy when you pick up the drug.

Treatment of stool incontinence

Initially, the treatment of stool incontinence consists of what you can do yourself, such as reviewing what you eat and pelvic floor training.

Write how often you have trouble

Part of the treatment of stool incontinence is that you record for a few weeks when you have stool incontinence in a diary. For example, you can answer the following questions:

  • How was the texture when it leaked?
  • Did something special happen before or when it leaked?
  • Could you have eaten something that affected?

The diary can then serve as support when you see your doctor again.

There are tools you can use

There is a special type of tampon that you can insert into the rectum, so-called anal tampons. The tampon has a sponge-like shape that keeps it in the rectum and prevents it from leaking. It also reduces the risk of it smelling.

You can use the anal vial when you have sex if you feel worried about it leaking.

There are also incontinence protectors you can use to protect your underwear.

You can get the resources printed on auxiliary cards, which are then included in the high-cost protection.

Training with biofeedback

One form of treatment is to train the strength of the ring muscles. You can do that with so-called biofeedback. It is a piece of electrical equipment that allows you to see or hear yourself when you squeeze your muscles. Then you know how you feel when you pinch.

The training is carried out with the help of specially trained nurses. It can sometimes last for a few weeks or months.  

Operation

Sometimes an operation may be needed. How the rectum and rectum are operated depends on why you have the stool incontinence.

For example, a surgeon can sew together muscles that have been damaged in connection with delivery. If the stool incontinence is due to a nerve injury, the ring muscle in the rectum can be strengthened by so-called pelvic floor plastic.

Muscles can also be strengthened by a doctor injecting a substance that fills the muscles.

You can also get electrodes implanted in the pelvis. They then stimulate the ring muscles and intestinal nerves.

If you have suffered major muscle damage, a piece of muscle from the thigh can replace the ring muscles. The muscle is then pulled in a loop around the rectum opening.

If you have a lot of problems and have not improved, you may need to be operated on so that you get a bag on the stomach that collects the stool, a so-called ostomy.

Influence and participate in your care

As a patient, you have under the Patient Act chance to affect your health.

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral to the open specialized care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should receive information about treatment options and how long you may have to wait for care and treatment.

You have the opportunity to get help from an interpreter. You also have the opportunity to get help from an interpreter if you have a hearing loss.

If you need tools, you should get information about what is available and how to get it.

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