Fecal Incontinence in Adults

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Fecal Incontinence in Adults
Management of Fecal Incontinence in Adults

Fecal incontinence in adults is an inability to voluntarily control defecation, which in the lightest form is incontinence of gas, and in the most severe – incontinence of big loads of feces. This is one of the most significant problems in the elderly. Fecal incontinence is often associated with urinary incontinence. Patients, suffering from fecal incontinence, are usually too ashamed to look for help, so they do not get any adequate treatment. This makes a closed circle, which worsens the patients’ quality of life and creates additional difficulties to the patient or the person nursing him. 

Causes

  • One of the most frequent causes is constipation. Because of constipation the bowels become filled with stool and this is what causes fecal incontinence. In some cases defecation is reflexive when the rectum is filled.
  • Psychological causes (changes of usual environment, poor conditions for normal defecation).
  • In some cases the causes remain unknown.
  • Past surgeries, deliveries complicated by ruptured perineum – when sphincters, which close the entrance to the rectum, are damaged.
  • Bowel diseases (diarrhea, tumors, inflammatory diseases), long term use of laxatives.
  • Diseases of the nervous system (dementia, Parkinson’s disease, diabetes mellitus neuropathies, spinal cord or brain injuries).

Social environment is very important in the development of fecal incontinence. For example, if the patient is put on diapers he will not even try to defecate voluntarily and will lose these skills quite fast. Therefore, tolerance, patience and knowledge are extremely important for nursing persons.

Signs and Symptoms

Fecal incontinence can be classified into three degrees:

  • I degree fecal incontinence – the incontinence of gas only. Feces are contained normally.
  • II degree – the incontinence of liquid feces, small loads, underwear is only smeared.
  • III degree – the incontinence of a large loads of feces, involuntary defecation of formed feces.

Examinations

These patients require an extremely careful examination. Case file, past diseases, surgeries and deliveries are very important. All examinations, that can help to determine the cause of fecal incontinence, are done. Variuos specialist’s consultations may be required: gynecologist, neurologist, surgeon, gastroenterologist, psychiatrist.

Treatment

The treatment of fecal incontinence depends on the cause. In some cases termination of certain drugs or the treatment of diarrhea or constipation may be enough. Sometimes surgery or intensive treatment of a brain disease may be required.

Prognosis

The prognosis depends on the patient’s general condition and the cause of fecal incontinence. If the exact cause is found, the condition has a better prognosis.

   

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