Urinary Incontinence Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Alvi incontinence is also known as faecal incontinence. This term is used to describe a person’s inability to control bowel movements so that stool or feces comes out unexpectedly from the rectum. Alvi incontinence can be in the form of discharge of feces in solid or liquid form.
This condition is more common in the elderly and women. The complaints are also quite diverse, from the occasional passing of small amounts of stool when passing gas to the complete loss of the ability to control bowel movements.
The ability to hold bowel movements, called continence, requires normal function of the rectum, anus, and nervous system. There are two muscles in the wall of the anus and rectum that function to hold back stool, namely the external anal sphincter and the internal anal sphincter.
Normal continence also requires the ability to rectal sensation, namely the ability to feel the presence of feces in the rectum, and rectal compliance, namely the ability to relax and ‘save’ stool if it is not possible to defecate at that time. In addition, physical and mental abilities are also needed to recognize stimuli for defecation (eg heartburn) and the ability to go to the toilet.
Symptom
Symptoms of urinary incontinence are quite varied. Starting from the inability to hold back gas, the release of feces during daily activities, the inability to hold stool before reaching the toilet, and so on. This situation can be accompanied by symptoms of diarrhea, constipation, and abdominal pain.
Normally, unrestrained stool does not occur in adults, except in cases of severe diarrhea.
Reason
Some things that can cause alvi incontinence include:
- Injuries related to childbirth. Is one of the most common causes found. It can cause tears in the anal muscles and damage to the nerves that control these muscles. Complaints can appear immediately after giving birth or many years later.
- Injury to the anal muscles. For example surgery on the anus or trauma.
- old age Aging can cause reduced muscle strength in the anus.
- Diseases related to the nervous system. For example stroke, diabetes, spinal cord injury, nerve damage due to excessive straining, and so on.
- Changes in bowel habits (more often caused by diarrhea, but can also be caused by constipation).
- Various medical conditions. For example Crohn’s disease, rectal prolapse, rectocele, and post-radiation therapy.
Diagnosis
To help establish a diagnosis, the doctor will conduct a history or medical interview and physical examination. Examinations performed included a rectal examination.
Some of the supporting examinations that may be carried out include:
- Anal manometry: measuring anal pressure and rectal sensation.
- Anorectal ultrasound or MRI: look at the muscular structures around the anus.
- Defecography: barium test to see the function of the anus and rectum during bowel movements.
- Proctosigmoidoscopy: use of a tube with a camera on the end to look inside the rectum and sigmoid.
- Anal electromyography (EMG): looks at the function of the nerves in the anal area.
Treatment
There are several treatment options to treat urinary incontinence. However, the choice of therapy depends on the cause and severity of symptoms.
Non-surgical treatment options include:
- Diet changes. For example, avoiding spicy, fatty foods, preserved foods, especially smoked, dairy products, sources of caffeine, and so on.
- Medicines that make stools denser (for example, diarrhea medicines), making it easier to control bowel movements.
- Treat medical conditions that cause urinary incontinence (eg Crohn’s disease ).
- Exercises to strengthen the anal muscles.
- Bowel training. For example, trying to defecate every day at the same time or biofeedback (physiotherapy to help strengthen the anal muscles and help increase rectal sensation).
Surgical treatment options include:
- Muscle repair: repair damaged anal muscles
- Stimulation of nerves with tools, so that muscle control improves
- Inserting substances into the anal canal to help compact and strengthen the ability to ‘clamp’ the muscles when holding bowel movements
- Colostomy, part of the large intestine removed through the abdominal wall and its contents accommodated in a bag