Accidental gas or stool leakage, soiling
Accidental gas or stool leakage, soiling
Stool incontinence (stool leakage, spontaneous leakage of stools and gases, fecal incontinence) is a very serious problem that greatly reduces the quality of life. It can mean the patient's inability to recognize the need to void or the inability to retain the contents of the rectum, leading to an unwanted and uncontrolled leakage of intestinal gases or liquid or solid stools. However, the term stool incontinence also includes fecal urgency, meaning that the arrival of feces in the rectum causes strong contractions and unexpected anal relaxation with possible accidental leakage. Soiling is a special case, being a condition involving spontaneous gas or stool leakage without the patient‘s noticing it. A large percentage of patients initially conceal this problem from their doctor due to embarrassment. For this reason, it is difficult to ascertain precise details of the occurrence of this condition in the population. However, women suffer from it more often than men, and as they get older, the frequency of the problem increases.
If we wanted a simple definition, stool incontinence is a condition whereby the patient is unable to perceive the contents of the rectum and/or to empty it in a suitable place at the appropriate time.
What is the cause
Stool leakage
The causes of this condition vary and the problem can occur on several different levels. The most common causes include a prolapse of the mucous membrane of the rectum, advanced age, which is associated with a disorder of the nervous system in the area of the rectum, injuries resulting from childbirth, hemorrhoids, perianal fistula and inflammation, tumors in the area of the rectum, and surgical and gynecological operations. However, there is a much wider and varied set of other possible causes, which can mean it is necessary to consult a proctologist, gastroenterologist, physiotherapist or a urogynecologist. The most common structure that is damaged is the sphincter.
How the problem is diagnosed
The diagnostics are actually performed by the patient herself: spontaneous and unwanted gas leakage, runny or solid stools. Stool urgency involves a sharp pressing to move the bowels with the inability to delay voiding for more than 15 minutes which may be followed by a spontaneous and unwanted leakage. Soiling is a spontaneous gas or stool leak without the patient's knowledge, which they only discover has occurred at a later time.
How the problem is treated
The examination should be performed by a proctologist. Imaging methods such as ultrasound, magnetic resonance imaging or special X-ray methods are used. Sometimes an anorectal manometry is required. Treatment does not have to involve an operation and often rehabilitation is appropriate. Sometimes special aids can alleviate difficulties. Surgery is possible in a certain proportion of patients.