Faecal Incontinence

This is the involuntary passage of fecal matter through the anus or the inability to control the discharge of bowel contents.

What is Faecal Incontinence (FI)

Up to 24% of the population are affected, although the figure is likely to be higher because of underreporting of the issue.

This is the involuntary passage of fecal matter through the anus or the inability to control the discharge of bowel contents. Its severity can range from gas sneaking out uncontrollably to a full leakage of the bowel contents and up to 24% of the population are affected, although the figure is likely to be higher because of underreporting of the issue. Naturally, this has a significant impact on the patient’s quality of life, relationships, social life and mental health.

Causes include:

  • Nervous System Issues
  • Inflammatory Bowel Disease
  • Irritable Bowel Syndrome
  • Diabetes Mellitus
  • Multiple Sclerosis
  • Stroke
  • Older Age
  • Hormone Therapy
  • Diarrhoea
  • Faecal Urgency
  • Urinary Incontinence

Mothers are also at risk of developing FI.

  1. During Pregnancy: During the late stages of pregnancy, physiological changes such as, increased transit time leading to altered stool consistency and increased intra-abdominal pressure, may contribute changes in incontinence for women with pre-existing pelvic floor or anal sphincter dysfunction.
  2. Childbirth: During childbirth, injury to the pelvic floor muscle nerve supply can lead to the inability to use these muscles adequately. Damage to the pudendal nerve can occur through can become stretched and compressed. Anal sphincter laceration can lead to FI, however, not all anal sphincter injuries result in FI. Additionally, the use of instruments (ie. forceps or vacuum) during vaginal delivery can increase the risk of FI, particularly if an obstetric anal sphincter injury occurred. A 3rd or 4th degree tear is a bigger risk factor than a 1st or 2nd degree tear.

Treatment

Faecal incontinence often coincides with other pelvic floor, pelvic or abdominal health problems, like constipation, prolapse or urinary incontinence. Treatment strategies will depend on type of incontinence (fecal, flatus, overflow, urgency, stress, passive or coital). The International Consultation of Continence (ICI) recommend conservative options prior surgical intervention. This will often include education, counselling, lifestyle modifications, dietary interventions and pelvic floor manual therapy. A period of at least 6 weeks supervised pelvic floor muscle training is the gold standard approach. At Anatomy Physiotherapy, Suzanne takes a holistic approach, listening to your story, taking a detailed assessment which often involves a vaginal and rectal examination, to enable optimal patient management treatment options.