Do you also experience fecal incontinence? (Fecal Incontinence) - Don't be shy, let's talk about it!

Sometimes, when you are in the wind, when you laugh a little too loudly, or when you exercise, do you accidentally spill a little poop on your clothes? Or do you feel like you need to go to the toilet, but you can't control yourself when you run and open the door? This is a problem that many people have, but they are embarrassed to talk about in society. Due to this situation, many people stay at home and stay away from society due to fear and shame. But it doesn't have to be like that. Let's talk about this openly today.

Simply put, what is fecal incontinence?

This is very simple. We medically call this condition `(Fecal Incontinence)` or `(Bowel Incontinence)` when we are unable to control the passage of stool when we want to. It means passing stool when we don't want to, without realizing it. For some people, this can be something as minor as passing a little stool when passing wind. And for some, it can be a serious condition such as passing solid stool without any control.

Think of it this way: our body's bowel movements are like a well-coordinated team sport. Our pelvic floor muscles, rectum, and anus need to work together to hold in stool and expel it when needed. These muscles also need to be connected to nerves to send the signal to our brain that we need to go to the toilet. If something goes wrong in this process, we can end up losing control of our bowel movements.

There are two main types of this condition.

There are two main types of incontinence. Let's take a look at what they are.

How common is this condition really?

It's more common than you think. Research suggests that one in three people are affected by this condition. The truth is, going to the toilet is not something we do openly. That's why many people suffer from this problem out of shame and embarrassment. So remember, this is not just your problem.

What are the symptoms of this condition?

Some people may only experience this type of loose stool when they have diarrhea. But for others, it's something they experience every day. Here are some of the main symptoms:

• Unintentional passing of stool while passing wind.
• Leaking stool when exercising, walking, or engaging in physical activity.
• Feeling the need to defecate, but unable to control it until you get to the toilet.
• Finding feces on your underwear even after you've finished defecating normally.
• Inability to completely control bowel movements.

What could be causing this?

The main causes of this are diarrhea, constipation, and damage to the muscles or nerves that help control bowel movements. In addition, things like previous surgery can also contribute to this.

• Diarrhea: It is harder for the muscles to hold in liquid stools than solid stools. Prolonged diarrhea can weaken the muscles in the rectum and anus.
• Constipation: Frequent constipation can also weaken these muscles. Straining to have a bowel movement can also damage the nerves. Sometimes, when a hard stool gets stuck in a lump, fluid can leak out.
• Muscle damage: This can happen to women, especially during difficult childbirth. If forceps are used to deliver a baby or an episiotomy is made, the surrounding muscles can be damaged. Also, surgery for hemorrhoids or fistulas can cause muscle damage.
• Nerve damage: The same things that damage muscles, such as a difficult birth or surgery, can also damage nerves. This is especially true if the nerves that signal you to have a bowel movement are damaged. Conditions like diabetes and nervous system diseases also increase the risk.
• Decreased anal elasticity:Normally, the walls of our rectum are elastic enough to hold stool. But if for some reason, for example, a disease like ``Crohn's disease`` or radiation therapy for cancer, it becomes scarred, this elasticity is lost. Then the stool can no longer be held and begins to leak.
• Pelvic Organ Prolapse (POP): When the muscles in the pelvic cavity become weak, the organs such as the rectum, vagina, uterus, and bladder are not properly supported. This can cause them to sag downward. This condition can also be caused by the rectum falling into the anus (rectal prolapse) or the rectum pushing into the back wall of the vagina (rectocele).

Who is most at risk for this?

Although this condition can occur in anyone, some people are at higher risk.

What complications can occur due to this condition?

The skin around the anus can be damaged by stool leakage. It can cause redness, itching, and inflammation. Over time, skin sores (ulcers) can also develop.

How does a doctor diagnose this disease?

For this, you may see a gastroenterologist or colorectal surgeon. He or she will ask you about your symptoms. Then, they will perform a physical examination and a rectal exam. It is important to be open and honest about all your concerns during this time.

To find the exact cause, you may also need to do the following tests:

• Anorectal manometry: A test that measures the strength of the muscles in the rectum and anus.
• Endorectal ultrasound or MRI: Examines the structure of the muscles and tissues around the rectum to see if there is any damage.
• Anal sphincter electromyography (EMG): A test to check for nerve damage.
• Endoscopy: A small tube with a camera (scope) is inserted through the anus to examine the inside of the intestine for any problems, inflammation, tumors, or scarring.

How is it treated and managed?

Treatments vary depending on the cause and severity of the condition. Sometimes it can be controlled with lifestyle changes alone.

Changes in diet

If this condition is caused by diarrhea or constipation, changing your diet can make a big difference.

• If you have diarrhea, stay away from things like caffeine, alcohol, spicy foods, dairy products, and artificial sweeteners.
• If you have constipation, eat more fiber-rich foods (fruits, vegetables, legumes, whole grains) and drink at least 8-10 glasses of water a day.

Exercise and training

• Bowel training: Working with a doctor, you learn to have a bowel movement at a specific time of day (e.g., after drinking your morning coffee).
• Kegel exercises: Exercises that strengthen the muscles of the pelvic floor. These should be done daily.
• Biofeedback: A method of strengthening, identifying, and controlling the muscles around the anus, under the guidance of a specially trained therapist.

Medicines

Medicines for diarrhea and constipation are used for this purpose.

Surgery

If other treatments do not yield successful results, surgery may be considered.

• Sphincteroplasty: Re-suturing and repairing damaged anal muscles.
• Sacral nerve stimulation: Implantation of a small device under the skin to stimulate the nerve that controls the anal muscles and pelvic muscles.
• Colostomy: A surgery that is only done if no other treatment is successful. In this, a small opening is made in the abdomen, the large intestine is brought out through it, and a special bag is inserted to collect stool.

How can you take care of yourself?

When living with this condition, it is very important to take care of your physical and mental well-being.

Protect your skin

• Avoid wiping vigorously with toilet paper. Instead, use unscented moist towelettes.
• After each bowel movement, wash with warm water without soap, pat dry without rubbing.
• Apply barrier creams (e.g. those containing zinc oxide) that protect the skin.
• Avoid wearing tight clothing. Wear underwear made of moisture-wicking fabrics like cotton.

Mental well-being and social life

• If you are afraid to go out, use a pad or disposable undergarment.
• Before you go on a trip, make sure to go to the toilet and empty your bowels.
• Carry an extra set of clothes and toiletries in your bag.
• Whenever you go somewhere, find out where the toilet is and keep it in mind. That way, if there's an emergency, you won't have to worry.

We are taught from a young age that it is not good to talk about things like bowel movements in public. That is why many people are embarrassed to talk about it when it comes to this problem. But the truth is, bowel movements are a normal process in our body. If there is a problem with it, it is essential to talk to a doctor about it. So don't be shy. See your doctor and talk about this. He or she will recommend treatments and methods that will help you regain control of your bowel movements.