Fecal incontinence can be a complication of childbirth. Although fecal incontinence can occur at any age, it's more common in adults over 65. This condition is known as rectocele.Ī number of factors may increase your risk of developing fecal incontinence, including: In women, fecal incontinence can occur if the rectum protrudes through the vagina. The longer this lasts, the less likely the nerves and muscles will recover. The stretching of the rectal sphincter by prolapse damages the nerves that control the rectal sphincter. Fecal incontinence can be a result of this condition, in which the rectum drops down into the anus. Surgery involving the rectum and anus, such as hemorrhoid removal, can cause muscle and nerve damage that leads to fecal incontinence. Things such as surgery, radiation treatment or inflammatory bowel disease can stiffen and scar the rectum. If the rectum is scarred or stiff it can't stretch as much as it needs to, and excess stool can leak out. Usually, the rectum stretches to accommodate stool. Loss of storage capacity in the rectum.These swollen veins can keep the anus from closing completely, letting stool leak out. Hemorrhoids are swollen veins in the rectum. Solid stool is easier to hold in the rectum than is loose stool, so the loose stools of diarrhea can cause or worsen fecal incontinence. ![]() Long-lasting constipation also may cause nerve damage that leads to fecal incontinence. This allows watery stool from farther up the digestive tract to move around the impacted stool and leak out. The muscles of the rectum and intestines stretch and eventually weaken. Chronic constipation may cause a dry, hard mass of stool to form in the rectum and become too large to pass. Repeated straining during bowel movements.Many things can damage these nerves, including: Injury to the nerves that sense stool in the rectum or those that control the anal sphincter can lead to fecal incontinence. This is most commonly due to having an episiotomy or using forceps during delivery. This kind of damage can occur during childbirth. These rings are known as the anal sphincter. Injury to the rings of muscle at the end of the rectum may make it difficult to hold in stool. Scheduled voiding is a useful first-line treatment in many cases of incontinence.For many people, there is more than one cause of fecal incontinence. Urodynamic studies are of benefit in establishing the cause of incontinence. There are three major mechanisms responsible for poststroke urinary incontinence: 1) disruption of the neuromicturition pathways, resulting in bladder hyperreflexia and urgency incontinence 2) incontinence due to stroke-related cognitive and language deficits, with normal bladder function and 3) concurrent neuropathy or medication use, resulting in bladder hyporeflexia and overflow incontinence. Forty-six percent of incontinent patients treated with scheduled voiding alone were continent at discharge compared with 17% of patients treated pharmacologically. All of the patients with hyporeflexic bladders had underlying diabetes or were taking anticholinergic medications. All of the patients with normal urodynamic studies were aphasic, demented, or severely functionally impaired. Urodynamic studies, performed on all 19 incontinent patients, revealed bladder hyperreflexia in 37%, normal studies in 37%, bladder hyporeflexia in 21%, and detrusor-sphincter dyssynergia in 5%. Incontinence was associated with large infarcts, aphasia, cognitive impairment, and functional disability (p < 0.05) but not with age, sex, side of stroke, or time from stroke to entry in the study. Nineteen patients (37%) were incontinent. ![]() Urodynamic studies were performed on all incontinent patients. The presence of urinary incontinence was correlated with infarct location, neurological deficits, and functional status. We prospectively studied bladder function in stroke patients to determine the mechanisms responsible for poststroke urinary incontinence.įifty-one patients with recent unilateral ischemic hemispheric stroke admitted to a neurorehabilitation unit were enrolled.
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