Fecal Incontinence Treatment Dubai by Dr Khaldoun Ghareb
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Fecal Incontinence

Fecal Incontinence

Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control. Losing control over defecation can lead to isolationism, frustration, and social distancing.
Fecal incontinence can be embarrassing. But don’t shy away from talking to your doctor. Treatments can improve fecal incontinence and your quality of life.

Causes:

Common causes of fecal incontinence include diarrhea, constipation, and muscle or nerve damage. Muscle or nerve damage may be associated with aging or with giving birth.
Whatever the cause, fecal incontinence can be embarrassing. But don’t shy away from talking to your doctor. Treatments can improve fecal incontinence and your quality of life.

Symptoms:

Fecal incontinence may occur temporarily during an occasional bout of diarrhea, but for some people, fecal incontinence is chronic or recurring. People with this condition may be unable to stop the urge to defecate, which comes on so suddenly that they don’t make it to the toilet in time. This is called urge incontinence.
Another type of fecal incontinence occurs in people who are not aware of the need to pass stool. This is called passive incontinence.
Fecal incontinence may be accompanied by other bowel problems, such as:
  • Diarrhea
  • Constipation
  • Gas and bloating

Causes

For many people, there is more than one cause of fecal incontinence.

Damage to the Anal Sphincter Muscle

  • Any damage to the anal sphincter at the end of the rectum will make stool difficult to hold. This occurs during childbirth, for example, if it is difficult, and the use of episiotomy or forceps to assist in childbirth.

Nerve Damage

  • There are nerves that sense incoming stool in the rectum and nerves that control contractions of the anal sphincter. Any damage to these nerves will lead to fecal incontinence. This nerve damage may occur due to the following:
    • Constant straining during bowel movements or due to a stroke or spinal cord injury.
    • Some diseases, such as diabetes and multiple sclerosis, also affect these nerves and cause damage that results in fecal incontinence.
Chronic constipation may be a hard, dry stool called stool that has been lodged in the rectum and is too large to defecate and is larger than the anus. Muscles in the rectum and intestine stretch, causing them to eventually weaken. This allows watery stools deeper in the digestive system to move around the hard stool and leak out. Chronic constipation can also cause nerve damage and fecal incontinence.

Diarrhea

  • Solid stool in the rectum can be easier to retain than liquid stool, so diarrhea may cause or even increase fecal incontinence.

Hemorrhoids

  •  Hemorrhoids may prevent the anus from closing completely when the veins in the rectum swell and allow stool in the rectum to leak out.

Rectal Defect

The rectum expands when needed to accommodate stool. But a fractured or hardened rectum cannot stretch enough, and excess stool leaks out.

Surgery

For example, surgery to treat hemorrhoids treat, enlarged veins of the rectum, and more complex surgeries in the anus, may damage muscles and nerves, causing fecal incontinence.

Rectal Prolapse

If the rectum descends into the anus, fecal incontinence occurs.

Rectocele in Women

in the solution of rectal defecation from the vagina, fecal incontinence can occur.

Prevention

Depending on the cause, it may be possible to prevent fecal incontinence. These actions may help:
  • Reduce constipation. Increase your exercise, eat more high-fiber foods, and drink plenty of fluids.
  • Control diarrhea. Treating or eliminating the cause of diarrhea, such as an intestinal infection, may help you avoid fecal incontinence.
  • Avoid straining. Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence

Treatment

Artificial Implants Are a Non-surgical Treatment.

They are self-expanding artificial implants equipped with the so-called shape memory that makes them grow by absorbing body fluids, reaching a volume of 730% of their original volume within 48 hours only. The surgical device used to place them is called the delivery system and has ten dispensers. Each dispenser has a cannula for inserting the artificial implants in place in the internal and external anal sphincter spaces, where they are inserted through a specific delivery system. Some rare cases were resolved by the so-called implant departure easily and did not affect the efficacy.

Surgical Treatment for Fecal Incontinence

Surgery may be necessary if there is another problem, such as rectal prolapse or damage to the sphincter muscle due to childbirth. There are several surgical options:
The options include:
  • Sphincteroplasty (Repair of the anus): This procedure repairs a damaged or weakened anal sphincter that occurs during childbirth. Doctors identify an injured area of muscle and free its edges from the surrounding tissue. They then bring the muscle edges back together and sew them in an overlapping fashion, strengthening the muscle and tightening the sphincter.
  • Treating hemorrhoids or rectal prolapse:A rectocele or hemorrhoids. Surgical correction of these problems will likely reduce or eliminate fecal incontinence. 
  • The artificial Sphincter replacement.:The anal sphincter is replaced by an artificial sphincter. An artificial sphincter is implanted around the anal canal. It is a small piece that can be blown into. When inflated, it tightly closes the anal sphincter, and stool does not pass. When you need to defecate, the air is deflated, the anus is opened, and the stool is passed out. Then, when finished, the device inflates itself through a small external pump.

Colostomy

With it, the intestine is diverted to expel the stool from an opening in the abdomen instead of the anus, where the stool comes out into a special hanging bag. It represents the last resort if all other solutions fail.

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