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

Do you sometimes accidentally spill a little poop on your clothes when you laugh out loud, exercise, or just take a breath? This is a problem that many people have, but are embarrassed to talk about in public. Many people suffer alone without telling anyone about it. But it's really nothing to be ashamed of. This is a medical condition. So let's talk about it openly today.

What is Fecal Incontinence?

Simply put, fecal incontinence is the involuntary loss of some or all of your stool when you don't want it to be. For some, this can be as minor as passing a little while passing wind. For others, it can be as severe as complete bowel movements without any control.

Our body's bowel and bladder control system is very complex. Think of it like a water tap. The muscles in our pelvic floor, rectum, and anus all need to work together properly. These muscles also need to receive the right signals from the brain. If there is a small weakness or damage anywhere in this system, this type of incontinence can occur.

There are two main types of this.

This situation can be divided into two main types. To understand this clearly, see the table below.

What are the main reasons for this situation?

There is no single reason for this. Several factors may be involved.

• Chronic Constipation: A person with chronic constipation may strain to defecate, damaging the muscles and nerves that control bowel movements. Also, the solid stool particles that are trapped inside may leak out.
• Diarrhea: Loose stools are more difficult to control than solid stools. Frequent diarrhea can weaken the muscles in the rectum over time.
• Muscle Damage: Women, especially, can suffer muscle damage if they have to use instruments like forceps during a difficult birth or have an episiotomy. This damage can also occur from surgeries for conditions like hemorrhoids.
• Nerve Damage: Things like childbirth and surgery can damage muscles and the nerves that control them. Conditions like diabetes mellitus and diseases of the nervous system can also weaken these nerves.
• Decreased elasticity of the rectal wall: The walls of the rectum, which hold stool, should be very elastic. However, conditions like Crohn's disease or radiation therapy for cancer can cause scarring and this elasticity can be lost. Then, even if the stool is slightly full, it can be difficult to hold it in and pass out.
• Pelvic Organ Prolapse (POP): When the muscles that hold the organs in our pelvic cavity (such as the uterus, bladder, and rectum) weaken, those organs drop down. If the rectum drops down in this way, it can cause problems with bowel control.

Who is at higher risk of developing this?

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

• Age: People over 65 are at higher risk. This is because muscles naturally weaken as we age. But don't assume this is a 'normal' part of aging. If you have this problem, definitely see a doctor.
• Gender: Women are at higher risk than men, especially after childbirth and menopause.
• Other medical conditions: People with the following medical conditions are also at higher risk.
• `Alzheimer's disease` and `Dementia`
• `Parkinson's disease`
• `Type 2 Diabetes`
• `Multiple Sclerosis (MS)`
• ``Inflammatory Bowel Disease (IBD)''
• ``Irritable Bowel Syndrome (IBS)''
• Stroke

What other problems can this cause?

Involuntary defecation can cause both physical and psychological problems.

• Skin infections: The skin around the anus is often moist and covered with feces, which can cause redness, inflammation, itching, and pain . Sometimes, ulcers can also form.
• Psychological impact: Many people actually feel more psychological stress than physical stress. Shame, anxiety, and stress can make you feel like you can't leave the house, hang out with friends, or go to events. This can make you feel like you're being left out of society.

How do you find this, Doctor?

First of all, don't be shy about talking to your doctor about this. This is a very common health problem for them. Only by talking openly about your problems can you get the right treatment.

The doctor will ask you about your symptoms and perform a physical examination. In addition, they may also perform tests to determine the exact cause.

• Anorectal Manometry: A test that measures the strength of the muscles in the rectum.
• `Balloon Expulsion Test`: A test that measures how efficient the process of expelling feces is.
• `Endorectal Ultrasound` or `MRI`: Check the structure of the rectal muscles and whether there is any damage.
• `Anal Sphincter Electromyography (EMG):` A test to check for nerve damage.
• Endoscopy: Examination of the inside of the intestines (Colonoscopy) or rectum (Proctoscopy) using a tube with a camera.

What are the treatments for this?

Treatment methods vary depending on the cause and severity of the condition.

Changes in diet

If your problem is due to diarrhea or constipation, changing your diet can provide great relief.

• If you have diarrhea: Reduce caffeine (coffee, tea), spicy foods, dairy foods, and artificial sweeteners.
• If you have constipation: Eat more fiber-rich foods (fruits, vegetables, whole grains). Drink at least 8-10 glasses of water a day.

Exercise and training

• Bowel Training: Getting used to going to the toilet at a specific time each day (e.g. after drinking your morning coffee). This creates a habit in the body.
• Kegel Exercises: These are very important. You can ask your doctor or physical therapist how to do these exercises correctly to strengthen the muscles in the pelvic area.
• Biofeedback: This is a method that uses a special device to identify and strengthen the muscles that help you control your bowels.

Medicines (drugs)

Your doctor may recommend medications to control diarrhea or medications to treat constipation.

Surgery

If other treatments are unsuccessful, surgery may be necessary. There are various types of surgery, such as sphincteroplasty to repair damaged muscles or sacral nerve stimulation. In very severe cases, a colostomy may be necessary.

Things to pay attention to when living with this condition

While receiving treatment, there are several things you can do to manage this condition and live well.

• Protect your skin:
• Wash with lukewarm water without soap after each bowel movement.
• Rather than scrubbing vigorously with toilet paper, gently clean with moist towelettes and dry thoroughly.
• Apply something like a diaper rash cream ('barrier cream') to protect the skin.
• Instead of tight clothing, wear underwear and clothes made from breathable fabrics, such as cotton.

• Think about mental well-being:
• If you're nervous about going out, use a pad or disposable undergarment. This will boost your confidence.
• Before leaving the house, go to the toilet and empty your bowels.
• Keep an extra set of clothes and wet wipes in your bag. It will give you a lot of peace of mind.
• Always check where the toilet is before you go. That way, if there's an emergency, you won't have to worry.

fecal incontinence sinhala, bowel incontinence sinhala, loss of bowel control, involuntary bowel movements, stool leakage, rectal diseases, bowel diseases