Incontinence is defined as the uncontrolled excretion of feces or gases for at least 1 month in a person older than 4 years, provided that these physiological functions were previously controlled.
Reasons for incontinence
It is rare to single out one underlying cause for the development of this condition. In almost all patients, the development of fecal incontinence has several causes, and the disease is considered as complex.
Pregnancy, chronic diarrhea, diabetes mellitus, previous coloproctological interventions, urinary incontinence, smoking, obesity, sedentary lifestyle, Caucasian race are all risk factors for the development of incontinence.
The function of retaining feces and gases is due not only to the anatomical integrity of the sphincter, but also to the consistency of feces, as well as the state of the nervous system. According to the form of development of fecal incontinence, organic (when the integrity of the sphincter is broken), inorganic (functional) and mixed are distinguished.
Currently, we do not have detailed statistics on who is more likely to suffer from this disease and why. The prevalence, according to various studies, varies from 1.4% to 18%. According to the Maternal Health Study, which included nearly 6,000 women 45 years of age and older, 20% of participants had episodes of fecal incontinence at least once a year, while 9.5% experienced this problem once a month.
Treatment methods for incontinence
Diet and medical supervision are recommended as the primary therapy for patients with fecal incontinence. Particular attention should be paid to the effects of caffeine, sweeteners, lactose, and other food additives that may cause diarrhea. In 22-54% of patients, adherence to the diet has a positive effect. Evacuation of intestinal contents using enemas or suppositories leads to a decrease in the volume of rectal contents and may reduce the risk of episodes of incontinence in some patients.
Currently, sacral neuromodulation is considered as the first line of surgical treatment for fecal incontinence. All modern studies confirm that, on average, 79% (69-83%) of patients after such treatment note an improvement of more than 50% in episodes of fecal incontinence per week in the first year after surgery, and 84% notice an improvement in the long-term period (more 36 months)
A generator is installed under the skin, which sends weak impulses to the nerve fibers involved in the work of the bladder and intestines. The device normalizes urination, solves the problem of fecal incontinence, eliminates pelvic pain in patients with neurogenic disorders. The effectiveness of the method has been proven in studies involving more than 25,000 patients. Over the past 15 years, over 200,000 such systems have been installed.