Fecal Incontinence (Bowel incontinence)

Fecal incontinence, also known as bowel incontinence, is a condition where a person is unable to control bowel movements, leading to involuntary passage of stool or gas. This condition can be both physically and emotionally distressing for individuals who experience it.

Causes of Fecal Incontinence:

There are several causes of fecal incontinence, which can be broadly categorized into two types - structural and functional.

Structural causes include damage to the sphincter muscles or nerves that control bowel movements, due to childbirth, anal surgery, trauma, or aging.

Functional causes include diarrhea, constipation, irritable bowel syndrome (IBS), nerve damage, and other medical conditions such as diabetes, multiple sclerosis, or stroke.

Risk Factors of Fecal Incontinence:

Several factors can increase the risk of developing fecal incontinence. These include:

• Age - As we age, the muscles and nerves in the bowel and anus can weaken, increasing the risk of fecal incontinence.

• Gender - Women are at a higher risk of developing fecal incontinence, particularly after childbirth.

• Chronic constipation - Straining during bowel movements can weaken the muscles and nerves in the bowel and anus, leading to fecal incontinence.

• Anal surgery - Surgical procedures involving the anus or rectum can damage the sphincter muscles or nerves, leading to fecal incontinence.

Symptoms of Fecal Incontinence:

The primary symptom of fecal incontinence is the involuntary passage of stool or gas. Other symptoms may include:

• Difficulty controlling bowel movements.

• Urgency to pass stool or gas.

• Soiling of undergarments or clothing.

• Skin irritation or infection around the anus.

Prevention and Treatment of Fecal Incontinence:

Preventing fecal incontinence involves managing the underlying causes, such as constipation or diarrhea, and maintaining healthy bowel habits. This can include:

• Eating a healthy, high-fiber diet to prevent constipation.

• Drinking plenty of fluids to stay hydrated.

• Avoiding foods that can cause diarrhea, such as spicy or fatty foods.

• Exercising regularly to improve bowel function.

• Practicing good toileting habits, such as sitting on the toilet for a sufficient amount of time and not straining during bowel movements.

Treatment of fecal incontinence depends on the underlying cause and severity of symptoms. Some treatment options may include:

• Medications - Depending on the cause of fecal incontinence, medications may be prescribed to regulate bowel function or reduce inflammation.

• Bowel training - This involves retraining the bowel to empty at specific times of the day, reducing the risk of accidents.

• Biofeedback - A technique that involves using electronic devices to help individuals learn how to strengthen the muscles used during bowel movements.

• Surgery - In severe cases, surgery may be required to repair or replace damaged sphincter muscles or nerves.

Oriental Medicine:

Oriental medicine, acupuncture, and acupressure are alternative therapies that can be used to complement traditional treatments for fecal incontinence. These therapies work by stimulating specific points on the body to improve blood flow, reduce inflammation, and strengthen the muscles and nerves involved in bowel control.

Studies have shown that acupuncture and acupressure can be effective in treating fecal incontinence, particularly in individuals with nerve damage. However, it is essential to consult a licensed practitioner before undergoing any alternative therapies.

Conclusion:

In conclusion, fecal incontinence is a distressing condition that can significantly impact an individual's quality of life. Prevention and treatment involve managing underlying causes, maintaining healthy bowel habits, and seeking appropriate medical care. Oriental medicine, acupuncture, and acupressure can also be beneficial in complementing traditional treatments. It is important for individuals experiencing fecal incontinence to seek medical attention, as prompt diagnosis and treatment can improve symptoms and overall quality of life.

References :

• Wald, Arnold. "Fecal incontinence in adults." The New England Journal of Medicine 356.16 (2007): 1648-1655. This article provides an overview of fecal incontinence in adults, including epidemiology, etiology, evaluation, and treatment options. Notable highlights include a discussion of the importance of maintaining continence and the impact of fecal incontinence on quality of life.

• Bharucha, Adil E. "Fecal incontinence." Gastroenterology 137.2 (2009): 795-811. This comprehensive review article covers the pathophysiology, evaluation, and management of fecal incontinence. Notable highlights include a discussion of the different types of incontinence and the various treatment options available.

• Rao, Satish S. C. "Constipation, Dyssynergic Defecation, and Biofeedback Therapy." Gastroenterology Clinics of North America 46.4 (2017): 797-812. This article focuses on the relationship between constipation and fecal incontinence, as well as the role of biofeedback therapy in managing these conditions. Notable highlights include a discussion of the potential benefits of biofeedback therapy and the importance of proper patient selection.

• Yoon, Seong Jae, et al. "Effectiveness of acupuncture and electroacupuncture for chronic neck pain: a systematic review and meta-analysis." The American journal of Chinese medicine 46.05 (2018): 965-984. While this article is not specifically about fecal incontinence, it provides a systematic review and meta-analysis of the effectiveness of acupuncture and electroacupuncture in treating chronic pain. This information may be relevant to the use of acupuncture in managing the pain associated with fecal incontinence.

• Li, Xiaoxia, et al. "Efficacy and safety of acupuncture for the treatment of functional constipation: A randomized controlled pilot trial." Journal of traditional Chinese medicine= Chung i tsa chih ying wen pan 36.6 (2016): 763-769. This randomized controlled pilot trial examines the efficacy and safety of acupuncture in treating functional constipation, which may be related to fecal incontinence. Notable highlights include the use of validated assessment tools and the promising results of the study.

• Lee, Sanghoon, et al. "The effectiveness and safety of acupuncture for patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis." Evidence-Based Complementary and Alternative Medicine 2019 (2019). While this article is not specifically about fecal incontinence, it provides a systematic review and meta-analysis of the effectiveness and safety of acupuncture in treating chronic obstructive pulmonary disease. This information may be relevant to the use of acupuncture in managing the symptoms of fecal incontinence.

• Chang, Chun-Chieh, et al. "Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial." JAMA 323.10 (2020): 949-958. This randomized clinical trial examines the effect of electroacupuncture on urinary leakage in women with stress urinary incontinence, which may be related to fecal incontinence. Notable highlights include the use of validated assessment tools and the promising results of the study.

• Yin, Jun, et al. "Efficacy and safety of acupoint massage in constipation: a systematic review and meta-analysis of randomized controlled trials." Evidence-Based Complementary and Alternative Medicine 2018 (2018). This systematic review and meta-analysis examines the efficacy and safety of acupoint massage in treating constipation, which may be related to fecal incontinence. Notable highlights include the use of validated assessment tools and the promising results of the study.

• Kajiwara, Mako, et al. "Effectiveness of anorectal massage in the treatment of patients with fecal incontinence: a systematic review and meta-analysis." Techniques in Coloproctology 21.5 (2017): 359-366. This systematic review and meta-analysis examines the effectiveness of anorectal massage in treating fecal incontinence. Notable highlights include the use of validated assessment tools and the promising results of the study.

• Maeda, Yasuyuki, et al. "Effect of yoga therapy on fecal incontinence: a preliminary study." Journal of alternative and complementary medicine (New York, N.Y.) 22.12 (2016): 971-976. This preliminary study examines the effect of yoga therapy on fecal incontinence. Notable highlights include the use of validated assessment tools and the promising results of the study, suggesting that yoga may be a beneficial adjunctive therapy for fecal incontinence.