What is fecal incontinence?
Most of us take it for granted that we can control our bowels. We barely have to think about controlling the release of gas, liquid or solid (stools or feces) from the bowels. We do not have “accidents” nor are we “caught short,” unless perhaps we suffer a short-lived bout of diarrhea. Sometimes, however, control is lost because the bowels or the muscular ring (anal sphincter) around the anus do not function properly. Bowel contents can then escape.
Fecal (or anal) incontinence is the loss of stool, liquid or gas from the bowels at an undesirable time. It can occur at any age and may affect 1 in 12 people. It is certainly more common than was thought some years ago. Simple tests can often show where the problem is, and treatment is frequently successful.
Normally, the bowels and anal sphincter work together to ensure that the contents are not passed until we are ready. The bowels’ contents move along the bowels gradually. The sphincter has two main muscles that keep the anus closed; the inner (internal anal sphincter) ring, which keeps the anus closed at rest, and the outer (external anal sphincter) ring, which provides extra protection when we exert muscles ourselves or when we cough or sneeze. These muscles, the nerves supplying them, and the sensation felt within the bowel and sphincter all contribute to the sphincter remaining tightly closed. This balance enables us to stay in control (or continent).
What causes fecal incontinence?
Fecal incontinence occurs most commonly because the anal sphincter is not functioning properly. Damage to the sphincter muscles or to the nerves controlling these muscles, excessively strong bowel contractions, or alterations to bowel sensation can all lead to this disturbance of function.