This problem, consisting of the inability to voluntarily control the expulsion of feces and gases.
Anal incontinence, causes
The professional of coloproctology can detect several causes:
- Age. It is associated with a generalized muscular weakness.
- Childbirth. Sometimes, after giving birth, there may be injuries to the sphincters that prevent proper closure of the sphincters.
- Accidents or surgical interventions.
These injuries, especially during childbirth, can also produce an injury to the pudendal nerves, related to these sphincters, aggravating the problem. Incontinence can appear immediately, or sometimes years later, when more factors are added.
- Other causes are inflammatory diseases, tumors, rectal prolapse, etc. Even chronic diarrhea or irritable bowel or colon can cause leakage of liquid stool and the need to go urgently to the toilet. Diabetes, neurological or mental disorders or radiotherapy can also cause it.
How to assess it?
In order to propose an adequate treatment, a complete evaluation is essential in which the problem and its impact on the relationship life, factors such as childbirth, defecatory habits, diseases, medication, previous interventions, etc. are analyzed.
An anorectal exploration is necessary and through techniques such as endoanal ultrasound to assess the defect, if any, or manometry, consisting of measuring the pressure and functioning of the anal sphincters, among others.
Is it treatable?
Anal incontinence can be cured or improved in a large number of cases. Its treatment is very variable, and sometimes simple
- Hygienic-dietary norms or the use of medication such as fiber or astringents, among others, substantially improve the problem.
- Training and re-education of the anal sphincters through exercises.
- Techniques to stimulate the response of the nerves that control them (neuromodulation of sacral roots, or stimulation of a nerve from the ankle).
- Injection of fillers into the anus to correct small sphincteric defects or to create a better closure of the anal canal.
When to resort to surgery?
In some complex cases, the patient will have to resort to surgery.
- Sphincteroplasty is the surgical technique to repair the injured sphincters. In extreme cases, it is even possible to replace the sphincter with other muscles or with a device called an artificial anal sphincter, which requires considerable experience.
- Colostomy (anus in the abdomen) is only rarely necessary.