Why does not hold feces in an adult. Fecal incontinence: in women and men, the elderly, the basic principles of treatment. Fecal incontinence in the elderly

In such a situation, you need to urgently consult a doctor.

Fecal incontinence - encopresis disease

The reasons for the appearance of such a problem can be very serious. Being in such conditions is a physical and psychological feeling of discomfort at the same time.

Fecal incontinence or encopresis in other words can be of varying severity.

Doctors divide this problem into three degrees:

• 1 degree - the inability to keep gases;
• 2 degree - incontinence of gases, liquid feces;
• Grade 3 - inability to retain the liquid and solid state of feces.

Doctors distinguish 4 types of involuntary bowel movements:

1. Regular appearance of feces without corresponding urge.
2. Inability to retain stool when urge is present.
3. The inability to even partially retain feces at the time of coughing, physical activity or sneezing.
4. Age related incontinence.

What are the causes of the pathological condition

The origin of the reasons why this disease appeared is different. They can be both defects acquired at birth, and acquired over time.

1. Anatomical pathologies:
   • problems with the rectum (for example, after surgery for a tumor or hemorrhoids);
   • anal malformation.
2. Psychological disorders:
   • panic;
   • neuroses;
   • schizophrenia;
   • psychoses;
   • tantrums.
3. Injuries acquired after the birth process or with a brain injury.
4. Diarrhea provoked by an acute infectious infection.
5. Injuries of the rectum of the obturator apparatus.
6. Neurological abnormalities caused by damage to the pelvis, tumors of the anus, diabetes mellitus.
7. Alcohol addiction.

It should be said that alcoholism is a very common cause of fecal incontinence in men and the treatment in this case is to eliminate alcohol dependence.

Also, the causes of this problem may have a completely different origin.

For example, perhaps due to serious medical conditions such as:

• manic-depressive syndrome;
• epilepsy;
• psychological instability;
• catonic syndrome;
• dementia.

Sometimes after childbirth, signs of encopresis appear. In general, absolutely all damage to the anal apparatus can lead to such a case.

If you find at least some signs of the onset of this disease, even the slightest, you should immediately seek help from a neurologist, proctologist.

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The onset of the disease in adults

Childbirth, which can provoke damage to the intestines or pelvis, is a common cause of fecal incontinence in women and treatment in this case should be comprehensive.

Also, a common cause is the loss of control over the defecation process due to a malfunction of the external sphincter, as well as anal insufficiency. Chronic diseases, pathologies of the nervous system can lead to such consequences.

• in a dream;
• in fainting spells;
• under stress;
• with other uncontrolled processes of loss of consciousness.

For an adult, unlike small children, this causes a lot of inconvenience and the feeling of comfort will immediately disappear.

Encopresis in the older generation

In older people, encopresis is a very common problem. It happens in the course of improper activity of the cortical center responsible for the process of defecation.

In the elderly, this problem is not congenital, but it appears with the advent of age, which means that this is an already acquired disease. Doctors can often witness a receptor inability to retain stool in the absence of the urge to have a bowel movement.

Since the cause may be hidden in the psychological state of a person, treatment is prescribed with medications and, in addition, a consultation with a psychotherapist is prescribed.

Sometimes it happens that the results do not bring positive dynamics for a long time, this is because the disease is already very advanced.

Problems after childbirth

Childbirth leads to serious consequences. Injury can be obtained both during natural childbirth and during caesarean section.

Often problems with the anal sphincter occur after the use of vacuum fetal extraction or as a result of the application of obstetric forceps. Perineotomy also causes an inability to retain stool.

The level of hormones falls with age, which means that muscle tissue loses its properties and elasticity, as a result of which the sphincter becomes more vulnerable. Overweight and chronic diseases can also provoke illness during pregnancy and labor.

After six months, many women manage to put their health in order. But there are those whom this problem does not leave for a very long time.

Basic principles of treatment

1. The very first thing you need to try to restore a constant bowel movement. This is where a fiber-rich diet can help. And in addition, you need to drink drugs such as imodium.
2. It is necessary to start training the sphincter. This will help prevent a relapse in the future. Auto-training will help raise the sensitivity of the intestine to the presence of feces in it to the desired level. These methods help in 70 percent of cases.
3. If the above methods do not bring results, then you will have to resort to surgery. In rare cases, a patient has to undergo a colostomy. With its help, the patient creates a direct path between the wall of the abdominal cavity and the large intestine. That's just the anus has to be closed and defecation occurs in a specially attached container, which is fixed near the abdominal wall.
4. A visit to the clinic made on time can deprive you of a large number of problems. Everything can be fixed in a short time, unless, of course, everything is left to chance. Do not be afraid to contact competent specialists who will certainly help you.

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Prevention of fecal incontinence

The development of this disease can be prevented, it is enough to follow a few simple rules and follow some recommendations:

• It is important to undergo an examination and treat diseases in the proctological part during the examination.
• Sexual intercourse through the anus should be avoided.
• Do not tolerate defecation if desired.
• It is advisable to train the muscles of the anal passage. It is enough to compress and relax the muscles in an accessible place and at the right time for you.

There is also a general set of exercises that involves the development of all muscles.

Even at the slightest sign, consult a doctor, do not neglect your or the health of your loved ones.

Medical treatments for encopresis

Fecal incontinence is medically known as encopresis. Very often it occurs against the background of other diseases. Therefore, in order to conduct effective drug treatment, it is necessary to conduct a comprehensive diagnosis and identify all health problems. Depending on the underlying causes, medical treatments come down to:

• surgical intervention;
• conservative methods.

Surgery has shown satisfactory results for many years. An operation may be prescribed in a situation where an involuntary bowel movement is caused by injury or a defect in the sphincter. Experts refer this procedure to the category of plastics.

Given the degree of damage to the sphincter and the length of the defective area, operations are divided into types.

1. Sphincteroplasty is an operation that is performed in case of damage to no more than a quarter of the sphincter circumference.
2. Sphincterogluteoplasty is a procedure that is required for large amounts of damage. During the operation, material from the gluteus maximus muscle is used to restore sphincter function.
3. Operation Tirsha. It implies the use of synthetic materials or silver wire. It is practically not used in modern medicine.
4. Fireman operation. For its implementation, the material of the thigh muscle is used. This procedure has a short-term positive effect.
5. In cases where incontinence problems are not associated with mechanical disorders, postanal reconstruction is performed.

In addition to surgical intervention, medications have proven themselves well to eliminate the problem of fecal incontinence. They are most often used in case of functional disorders of the digestive system. It can be diarrhea, frequent loose stools, a combination of incontinence along with constipation.

All drugs are divided into two groups. The task of the first is to eliminate the signs of the underlying disease. The purpose of the second group is to influence the muscle tone in the perineum and sphincter. Strychine in tablets, subcutaneous injections of prozerin, ATP vitamins, group B showed high efficiency. With increased muscle excitability, the use of tranquilizers is recommended.

Traditional medicine recipes

When diagnosing encopresis, along with medications, it is recommended to use traditional medicine methods. They are aimed at the general improvement of the patient's well-being and the normalization of the body.

For effective treatment, it is necessary to normalize nutrition, try to minimize situations that lead to nervous excitement. Optimally - a peaceful environment, complete tranquility.

Every day for at least a month, you should put an enema from a decoction of chamomile flowers. For the procedure, it is necessary to introduce 400 ml of the finished broth into the rectum. After that, you should walk around with him inside. The procedure time is as long as possible. The broth should be warm. The temperature ranges from 22 to 38 degrees. Such enemas are not only therapeutic, but also training in nature.

Another folk method is training on a special tube. It is necessary to take a tube with a diameter of about 1 cm. For a length of 5 cm, it is smeared with petroleum jelly and inserted into the anal canal. After that, exercises are performed for the sphincter muscles. Exercises consist of sequential squeezing and unclenching muscles. Then you need to walk around the room, trying to first hold the tube, and then push it out.

For complex therapy, folk choleretic decoctions are used. They are necessary for the normalization of the gastrointestinal tract. The decoction of calamus roots proved to be the best. It is recommended to consume honey daily. A teaspoon is enough, rowan fruits and its juice are also good.

The active removal of toxins from the body is facilitated by a glass of water taken on an empty stomach with the addition of lemon juice. Excellent green tea, fresh fruit juice.

In addition to medications and exercises to strengthen the sphincter muscles, patients are prescribed a diet. The main task is to normalize nutrition for the proper functioning of the digestive system.

First of all, it is necessary to exclude from the diet those foods that can cause diarrhea: caffeine, alcohol. In case of lactose deficiency or poor protein tolerance, all dairy products are removed from the diet. It is not allowed to consume whole milk, cheese, butter, ice cream. It is also not recommended to eat fried, salty, spicy, smoked.

Diet foods should not be present in the diet. This means that sugar substitutes, sorbitol, xylitol, fructose and other components of the diet should be abandoned. It is best to organize the consumption of food in small portions, but at regular intervals. It can be 5-6 meals a day.

In the diet, you should add more cereals and dishes that contribute to the thickening of the stool. Be sure to daily intake of foods containing fiber: fresh vegetables and fruits. Bread is best purchased from coarse grains. Dietary fiber preparations can be used as a dietary supplement. With their help, the chair will become more plentiful and more manageable. Despite the ban on dairy products, kefir and other fermented milk drinks should be present in the diet. They have a good effect on the intestinal microflora and digestion.

What predictions for the development of the disease do patients with encopresis

Fecal incontinence is a fairly common disease that is caused by a variety of reasons. With a timely appeal to a specialist, the prognosis for its development is the most optimal.

If you do not pay attention to the disease and let it take its course, then encopresis begins to develop. It goes into more serious stages.

In total, there are 3 stages of the disease.

1. The first stage is characterized by gas incontinence. This is an unpleasant symptom, but it does not have a direct impact on a person's life. The patient can perform normal activities, live a full life.
2. In the second stage, incontinence of unformed feces occurs. This situation requires the intervention of a specialist in order to adjust the diet, prescribe drugs that will help thicken and form feces. It is recommended to perform gymnastics for the sphincter muscles. This stage of the disease is already noticeable to others, since the patient may not have time to reach the restroom in time. As a result, there is a gradual separation of the patient from the team. He avoids long mass events.
3. The third stage is characterized by the inability to retain even dense feces. In this situation, functional disorders of the sphincter muscles are possible. If medical methods and gymnastics do not help, then surgical intervention is indicated.

Despite the fact that the social standard of living of the patient is seriously affected, encopresis can be cured. Situations when fecal incontinence is caused by hemorrhagic or ischemic stroke are considered unfavorable for the prognosis. But it leads to a violation not only of the defecation process, but also paralysis, impaired speech and other problems.

What causes fecal incontinence and how to treat it

Fecal incontinence is a medical condition characterized by a disorder in which a person cannot control bowel movements. Colon cleansing is spontaneous. The patient loses calm, becomes psychologically unbalanced.

Fecal incontinence has a special medical term - encopresis. The disease is usually associated with the development of organic pathology. All factors are significant and require elimination, urgent medical attention.

Clinical description of the pathology and the principle of the defecation process

Fecal incontinence in adults is an unpleasant and dangerous phenomenon. A person loses the ability to control internal processes, bowel cleansing is not controlled by the brain.

Fecal masses can be of different consistency - solid and liquid. The emptying process itself does not change from this. Fecal incontinence in women is diagnosed less frequently than in the strong half of humanity. Statistics give figures - one and a half times less. But this does not allow women to be calm and confident that they are not afraid of such a pathology. The disease is nearby, waiting for favorable conditions and manifests itself, violating the usual way of life.

There is an opinion that a pathological disorder is characteristic of old age. Fecal incontinence in the elderly is an optional sign of age, doctors have proven that the opinion is erroneous. Statistical data provide figures that explain the emergence of such opinions. Half of the patients are people over the age of 45. Age is only one of the reasons that leads to illness.

To understand why fecal incontinence occurs, you need to understand the process of managing bowel movements. Who controls at what level of physiology it is laid down. Fecal mass output is managed by several systems. Their consistency leads to the normal functioning of the body.

1. In the rectum, a large number of nerve endings are concentrated, which are responsible for the work of muscle structures. The same cells are located in the anus. The muscles hold the stool in and push it out.
2. The rectum is located inside the intestine in such a way as to hold feces, send it in the right direction. The feces, once in the rectum, are already acquiring their final state. It is dense, compressed into voluminous ribbons. Anus closes his exit without control.
3. The compressed state of the bowel is preserved until the exit, when the person is ready for the act of defecation, he understands that he has come. In a normal state, a person can restrain the process until he can go to the toilet. The delay time can be calculated in hours.

The sphincter plays an important role in the process. More precisely, the pressure in his area. Normally, it varies from 50 to 120 mmHg. Men have a higher rate. The anal organ in a healthy state should be in good shape, a decrease in its functionality leads to a deterioration in defecation. The vegetative NS controls its activity. It will not be possible to consciously influence the sphincter. Stimulation of the exit of feces occurs at the level of irritation of receptors in the walls of the rectum.

Scientific Explanation of Excretion:

• simultaneous vibration of the muscles of the peritoneum and closure of the main opening (slit passage);
• increased pressure on the sphincter;
• delayed compression of intestinal segments;

All processes lead to promotion, pushing feces to the anus. The process is slow and does not tolerate acceleration. The muscles of the pelvis enter a relaxed state, the muscles open the rectal outlet. Relaxes the internal and external sphincter. When a person cannot get into the sanitary room, he strains the internal receptors, the anorectal opening remains closed, tight. The degree of tissue tension stops the urge to go to the toilet.

Causes of fecal incontinence

There are a number of factors that cause fecal incontinence in adults.

The most common reasons:

• constipation phenomena;
• liquid stool;
• weakness and damage to muscle mass;
• nervous conditions;
• decrease in muscle tone relative to the norm;
• dysfunction of the pelvic organs;
• hemorrhoids.

You can consider and analyze the reasons for fecal incontinence in detail.

1. Constipation. In the intestines, there is an accumulation of solid waste products from food processing. In the rectum, tissues are stretched, which relieve pressure on the sphincter. When constipated, a person has a desire to soften the feces. Loose stools accumulate over hard feces. There is leakage of them and damage to the anus.
2. Diarrhea. Diarrhea changes the state of the stool, this becomes a factor in the development of pathology. Treatment of fecal incontinence becomes the first and necessary action to eliminate symptoms.
3. Problems of the innervation plan. The impulses are subject to two types of disturbance. In the first version, the problem is based on nerve receptors, the second - on deviations in the brain. Often this is characteristic of the senile state, when the activity of brain processes decreases.
4. Scars on the walls of the rectum. Due to the decrease in the strength of the walls of the esophageal membrane, enuresis and encopresis begin to appear. Unpleasant processes violate the state of an adult organ, scars are formed. Sometimes scars form after inflammation, surgery, radiation.
5. Hemorrhoidal venous seals. The knots do not allow the hole to close, the muscles become weak and inactive. In older people, hemorrhoids alter the entire bowel movement.

Treatment Methods

It comes from certain principles:

• adjustment of the regimen and diet;
• medicines;
• training the muscles of the intestinal systems;
• stimulation of work with the help of electrical equipment;
• operational activities.

Each principle will be analyzed by a specialist. Treatment of encopresis is aimed at eliminating the problem - the cause that caused the violation of the bowel movement.

Medicines

Among the drugs that help normalize the digestive system, Imodium tablets are considered one of the most popular. In medical language they are called Loperamide.

Drug groups:

• antacids;
• laxatives;
• therapeutic.

Other antidiarrheals intervene in the disease and produce additional healing effects:

1. Atropine, Belladonna. Anticholinergic drugs, they reduce the development of secretion, increase peristalsis. The motility of the intestinal walls returns to normal. It can be used at various stages.
2. Codeine. The tool relieves pain, as it is one of the derivatives of the opium group of drugs. More often it happens that it is included in the group of dangerous contraindications. It is prescribed only on the advice of a doctor.
3. Lomotil. A medicine with this name reduces the movement of feces, creates conditions for its hardening.

The most common are activated charcoal tablets. The substance is named after the active element of the composition. Coal absorbs liquid, expands the feces in volume. In addition, the drug removes toxic substances from the body.

Home Treatments

The problem may arise in conditions of impossibility to contact a medical institution. Then you have to turn to the advice of healers, healers from the people. At home, the disease has been eliminated for many centuries. Treatment of fecal incontinence was carried out in the villages, where grandmothers picked up healing herbs and created miraculous tinctures.

You can use folk remedies, but such an action should not be permanent. What reasons led to loose stools, why did the intestines malfunction? Answers to questions can be obtained after a complete examination and diagnostic procedure.

1. Enemas. For their implementation, chamomile decoctions are used. Take 50 g of medicinal herbs, place it in a liter of boiling water. On a slow fire, they are waiting for the complete dissolution of the components of chamomile. Then cool to room temperature and injected into the rectum. You need to keep the medicine inside for a very long time, you can help with the help of medical devices or hands.
2. Infusions for internal use. The base is calamus grass. It is steamed in boiling water, proportions of 20 g of grass, 200 ml of liquid. Water compositions can not be done a lot. A liter of healing infusion is sufficient for a course of 7 days. Drink 1 spoon after meals.
3. Rowan juice. The fruits of the tree help fresh and pressed into a drink. The norm of admission is one spoon no more than 3 times a day.
4. Honey products. Honey, 1 tablespoon per day, will become both a curative and a preventive method for eliminating the disease.

Pathology after childbirth

A change in bowel movements occurs during pregnancy. Women hope that everything will be over after childbirth. More often the illness continues to be observed, to amplify. The problem becomes not so much physiological as psychological.

Fecal incontinence after childbirth is due to the following reasons:

• violation of the innervation of the muscles of the bladder;
• deviations in the work of the muscles of the pelvic organs;
• pathologies of the urethra;
• dysfunction of the closure of the bladder and urinary systems;
• pressure instability within the bladder.

Pathology goes along with another process - gas incontinence is observed. A large number of women turn to doctors after childbirth with such symptoms. They are trying to understand the reasons why gas incontinence appears after childbirth.

The reason for the phenomenon is not one, it is a whole complex:

1. Trauma to the anus during labor.
2. The birth of a large fetus against the background of ruptures of external and internal.

There are also medical pathologies that, with fecal incontinence, often become noticeable after childbirth.

Methods for the treatment of women's diseases

What to do to eliminate unpleasant symptoms, the attending physician will tell you.

The methods were developed by specialists, based on the experience of doctors in studying the cause of fecal incontinence.

1. Operations to introduce a special gel into the canal. This type of therapy is used to fix the walls of the anus. The method does not promise a complete cure, a relapse may occur.
2. Fixation of internal organs. Operations are rarely used. Surgeons fix the channel of emission of fluid, the cervix, the bladder. After the intervention, a long recovery period will be required.
3. Loop method. One of the most frequently performed methods of surgical intervention. To eliminate urinary and fecal incontinence, a support is created from a loop of special medical material.

Treatment after an injury to the sphincter region or damage to the muscle tissue of the pelvis is the method of modern technology - sphincteroplasty. The surgeon stitches torn, stretched muscles. Another way is an artificial organ, it can be controlled by a person himself. The surgical cuff is inflated and deflated. Fecal incontinence after surgery can be covered by simple measures: clean, changeable clothes, taking medications that reduce the smell of stools accompanied by gas.

Fecal incontinence in the elderly

Treatment for encopresis depends on the age of the patient. Fecal incontinence in the elderly is a common problem.

What is diarrhea, almost everyone knows. Under certain conditions, a single aggravation becomes a frequent ailment. Knowing the causes and factors of its development will help to avoid pathology, to maintain the usual way of life.

Encoprez is a big problem, but folk remedies solve it

A rather unpleasant pathology characterized by fecal incontinence or a temporary or congenital inability to control the act of defecation is called encopresis. Absolutely anyone can face this disease, regardless of gender and age. Therapy of the disease should be immediate and appropriate. Treatment of encopresis with folk remedies is acceptable and possible, but only as an additional one.

According to statistics, pathology is more common in children, mostly boys aged 5 years. In adults, the disease is rarely diagnosed. The development of the disease is more susceptible to women who have had a difficult birth.

In addition, the problem becomes especially relevant with age. The disease develops due to degenerative changes caused by natural aging. Encopresis in the elderly is diagnosed one and a half times more often than in adults under 50 years of age.

What provokes the development of the disease and how to deal with it?

Fecal incontinence in adults can develop against the background of malformations, as well as rectal defects. These reasons are congenital. There are many more acquired causes. So, pathology can develop due to:

• malnutrition;
• muscle hypotension;
• postoperative or postpartum trauma;
• metabolic disorders;
• mental deviations: psychosis, schizophrenia, hysteria;
• rectal fistulas;
• diabetes;
• rupture of the rectum;
• domestic or surgical trauma of the pelvic organs;
• tumors of the anus;
• brain damage.

The disease is unpleasant, bringing a lot of discomfort to a person’s life. Treatment of the disease must be timely. Only a doctor can prescribe the use of this or that drug. Along with traditional therapy, it is recommended:

• eat properly;
• exercise the pelvic floor muscles
• empty regularly;
• use drugs from medicinal plants.

Patients are prescribed a diet. Recommended inclusion in the diet: soybeans, lentils, peas, beans, bran, fruits (apples, peaches and pears are not allowed), brown rice, nuts, whole wheat pasta, potatoes, pumpkin, dried fruits, flaxseed, oatmeal.

Avoid eating dairy products, drinks, sweets, caffeinated foods, spicy and fatty foods, sausages, ham, sausages, and alcoholic beverages. People suffering from the disease need to observe the drinking regimen. During the day, it is recommended to drink two liters of purified non-carbonated water.

Means of alternative medicine in the fight against fecal incontinence

The use of this or that drug must be approved by the attending physician. In no case do not self-medicate, it can harm you and cause the situation to aggravate.

1. Application of enemas. For a month, it is advised to do cleansing enemas. For this purpose, it is recommended to use chamomile decoction. The same folk remedy can be used for training enemas. Brew 50 grams of plant flowers in a liter of boiled water. Boil the composition over low heat for a quarter of an hour. Cool and use for bowel cleansing. As for training enemas, here it is necessary to use about 300 ml of a decoction of 30 - 40 degrees. Enter the composition into the rectum and try to keep it as long as possible.

2. Infusion of calamus will help in the fight against the disease. Steam 20 grams of dried finely chopped plant roots with boiling water - 200 ml. Remove the product for an hour in a warm place, or rather insist in a thermos. Take a spoonful after each meal.

3. Rowan against encopresis. It can be used for treatment, both fresh fruits of the plant and freshly squeezed juice. Take a spoonful of berries or juice three times a day, after meals.

4. Honey is the perfect natural medicine. Consume 10 grams of honey three times a day.

Treatment of encopresis in children

Encopresis in children is a fairly common occurrence. Doctors recognize pathology, first of all, psycho-emotional, but they also do not exclude congenital pathologies. The occurrence of the disease may be due to:

• craniocerebral injuries;
• pathologies of fetal development;
• complications during childbirth;
• congenital anomalies of the lower intestine;
• general neurotic disorders;
• emotionally unstable situation in the family;
• psychosomatic disorders;
• acute inflammatory processes in the gastrointestinal tract;
• improper functioning of the nerve receptors of the anus.

Unfortunately, not all parents can immediately identify the pathology. The child in any case will hide the problem, even if he is only four years old. Therefore, mom and dad need to be as attentive to their child as possible. If you find a problem, the first thing to do is contact your pediatrician. The sooner therapy begins, the sooner your baby will get rid of the disease.

Treatment of encopresis in children should be comprehensive. Along with the therapy prescribed by a specialist, it is recommended to use non-official medicine. They will contribute to the speedy elimination of the disease.

Since encopresis is often accompanied by constipation, dietary intake should be followed in order to prevent the accumulation of feces in the intestines. In the diet of the baby, it is recommended to keep vegetable soups, cabbage dishes, dairy products, herbs, honey, dried fruits.

Also, in order to prevent constipation, before each meal, you need to give the baby 10 ml of vegetable oil. Sunflower or olive will do.

The use of enemas

In the treatment of encopresis with traditional medicine, enemas are of great importance. It is better to spend them in the morning. Cleansing procedures contribute to the development of an emptying reflex, and, importantly, do not leave feces for their involuntary release. Enema volume. The course of therapy is twenty procedures.

In order to reduce nervous tension, it is recommended to take therapeutic baths. To do this, you can use infusions of the following herbs: valerian, chamomile, calendula, sage, lavender, succession, motherwort, mint, calamus. An excellent effect can be achieved using fees.

Mix equal proportions of calamus rhizome with sunflower seeds and valerian roots. Brew 100 grams of raw materials in a liter of boiling water. After an hour, filter and add to the bath. The duration of the procedure is a quarter of an hour. Better to spend in the evening.

Combine equal amounts of lavender with mint, lemon balm, rosemary, thyme, thyme, sage, fume, and mallow. Steam 150 grams of the mixture in a liter of boiled water. Let the composition brew. After straining, pour into the bath. The duration of the procedure is 20 minutes.

Folk remedies in the treatment of the disease are effective and efficient. However, you must understand that the process of therapy itself is laborious and lengthy. The right approach, the implementation of all doctor's prescriptions and proper nutrition - all this contributes to a speedy recovery.

Fecal incontinence - causes, diagnosis, treatment

What is fecal incontinence

The mechanism of development and causes of fecal incontinence

1. Psychogenic fecal incontinence, which can lead to neurotic and hysterical psychoses, pathocharacterological personality disorders, dementia.

2. Against the background of mental illness (dementia, schizophrenia, epilepsy).

Group 1 - against the background of diseases related to the digestive tract and excretory system (rectal prolapse, trauma to the anus, accumulation of a large amount of solid feces in the rectum).

Practical classification of fecal incontinence

In practice, fecal incontinence is usually divided into degrees of severity:

I degree - manifested in gas incontinence.

II degree - characterized by incontinence of unformed feces.

III degree - is expressed in the patient's inability to hold dense feces.

Epidemiology and statistics of fecal incontinence

Diagnosis of fecal incontinence

• Endorectal ultrasonography. Thanks to this method, it is possible to assess the thickness of the sphincters of the anus (external and internal). In addition, the method allows you to detect the presence of defects that cannot be detected by manual examination.
• Anal manometry. This method consists in determining the resting pressure and the tension created in the anal canal. Anal manometry can be used to assess the tone of the anal sphincters.
• Determination of volume-threshold sensitivity of the rectum. If there is a deviation from the norm (a decrease or an increase in this indicator), the act of defecation in the patient is disturbed, and this, in turn, leads to the absence of urge to defecate, or vice versa - causes urges that require immediate emptying of the intestine.

Treatment of fecal incontinence

1. Operation Tirsha- with the use of synthetic materials or silver wire (at present, it is practically abandoned).

2. Fireman operation- using the thigh muscle as a plastic material (its effectiveness, unfortunately, is short-lived).

• Complex exercises aimed at training the anal sphincter(were developed by scientists Dukhanov, Kegel). The essence of these exercises is that through the anus, a rubber tube is inserted into the rectum, previously lubricated with petroleum jelly. The patient on command compresses and relaxes the anal sphincter. Exercises are performed daily for 5 sessions. The duration of 1 session is 1-15 minutes. The therapy cycle is designed for 3-8 weeks. In parallel with these exercises, it is recommended to perform physical exercises aimed at strengthening the muscles of the gluteal region, abdominals and adductors of the thigh.
• electrical stimulation- is carried out in order to stimulate the nerve endings responsible for the formation of a conditioned reflex to defecate.
• Biofeedback. This technique has been practiced in the world for more than 30 years, but in Russia it has not yet become popular. Foreign colleagues note that this method, in comparison with others, gives not only the most positive results, but also the most persistent ones.

I would like to pay special attention to this technique. It is carried out with the use of biofeedback medical devices. The principle of operation of the biofeedback device is that the patient is given the task of reducing and the ability to delay the tension of the external sphincter in a given mode. Using a rectal sensor, an electromyogram is recorded, and the information is displayed on a computer in the form of graphs. The patient, upon receiving information about how correctly the task is performed, can consciously control and adjust the duration and strength of the contraction of the sphincter muscles. This, in turn, significantly increases the effectiveness of external sphincter training, and helps to restore the cortico-visceral pathways, which are responsible for the function of retaining intestinal contents. When using this method, it is possible to achieve positive results in 57% of cases.

Prognosis for fecal incontinence

Fecal incontinence as a symptom of other diseases

Within the framework of this article, we will not consider in detail the immediate causes, course and treatment of stroke. Let us draw your attention only to what symptoms are accompanied by these pathologies.

As a result of a stroke, a patient develops a whole complex of disorders, which is associated with a violation of the blood supply to a certain area of ​​the brain. Depending on the affected area, certain symptoms are expressed to a greater or lesser extent.

• movement disorders or paralysis (impaired coordination of movement, difficulty walking, complete impairment of movement on one or both halves of the body);
• swallowing disorder;
• speech disorder (mainly with damage to the left hemisphere of the brain);
• violation of perception (there is no adequate perception of the surrounding reality);
• cognitive impairment (the ability to perceive and process information is reduced, logic is impaired, memory is reduced, the ability to learn is lost);
• behavioral disorders (slow reactions, emotional instability, fearfulness, disorganization);
• psychological disorders (sudden mood swings, causeless crying or laughter, irritability, depressive states);
• violations of urination and defecation (there is no control over physiological functions, the tone of the sphincter of the anal canal is disturbed).

2. Dysfunction of the pelvic organs

This name is understood as a complex of disorders from the pelvic organs. There are many reasons for the development of this condition. We single out the main ones: brain tumors, encephalitis, atherosclerosis, multiple sclerosis, mental disorders, epilepsy, Alzheimer's disease, malformations of the genitourinary organs, weakness of the pelvic floor muscles, rectal prolapse, uterine prolapse, enuresis, prostatitis, damage to the urinary tract and the excretory system of the intestine during surgical interventions and injuries.

• constipation;
• acute urinary retention;
• urinary incontinence;
• incomplete emptying of the bladder;
• pain during defecation and urination;
• false urge to urinate and defecate;
• fecal incontinence;
• impotence.

3. Spinal cord disorders

This group of disorders occurs when the spinal parts of the nervous system located in the spine are damaged. The causes of this group of disorders can be: meningitis, sygingomyelia, malformations of the spinal cord, multiple sclerosis, amyotrophic sclerosis, tuberculosis of the spinal cord, tumors of the spinal cord, spinal cord injury.

• movement disorders in the limbs (upper, lower);
• decrease or complete absence of sensitivity (tactile, temperature, pain; can be observed on one or both halves of the body, above or below the level of damage to the spinal cord);
• incontinence of feces and urine.

4. Injuries, including birth

This group of diseases is associated with a traumatic effect, in which the sphincter of the anal canal is affected and, as a result, fecal incontinence occurs. In the case of severe injuries, this group of diseases is characterized by a complex of symptoms, which depends on the size of the injury and the depth of the lesion. With birth injuries, pathology develops during difficult births, most often not in medical institutions. In both cases, patients are subject to surgical treatment with subsequent rehabilitation, which is selected individually.

Fecal incontinence

Fecal incontinence

What is fecal incontinence?

Who suffers from fecal incontinence?

• diarrhea;
• disease or injury that affects the state of the nervous system;
• general poor health caused by several chronic or long-term illnesses;
• difficult childbirth with injuries to the pelvic floor muscles, muscles, ligaments and tissues that support the uterus, vagina, bladder, rectum.

How does the intestine control bowel movements?

What are the causes of fecal incontinence?

• diarrhea
• constipation
• muscle damage or muscle weakness
• nerve failure
• decreased muscle tone in the rectum
• haemorrhoids
• pelvic floor dysfunction

Diarrhea. Diarrhea can lead to fecal incontinence. Loose stools fill the rectum faster and are harder to hold than hard stools. Diarrhea increases the chances of not getting to the toilet on time.

What tests are done for fecal incontinence?

• When did fecal incontinence start?
• How often do episodes of fecal incontinence occur?
• How much stool is leaking? Is it a chair or just soiled underwear? Is only a small amount of hard or loose stool leaking out? Or is there a complete loss of control over bowel movements?
• Is there a strong urge to defecate or does it occur without the urge?
• If there are hemorrhoids, do the hemorrhoids come out through the anus?
• How does fecal incontinence affect daily life?
• Does it appear that certain foods are more conducive to fecal incontinence?
• Is the patient able to control flatulence?

Based on the answers to these questions, the attending physician may refer the patient to a specialist doctor: a gastroenterologist, proctologist, or colorectal surgeon. The specialist will examine you and may suggest one or more of the following diagnostic tests, which may be performed in a hospital or clinic:

• Anorectal manometry uses a pressure-sensitive tube to examine the sensation and function of the rectum. Anorectal manometry also checks the ability of the anal sphincter muscles to provide the necessary contraction force and the ability to respond to nerve signals.

  On the radiograph (V.D. Pasechnikov): defecography of a normal act of defecation (left) and obstructive defecation (right).

  • Sigmoidoscopy, in which a flexible tube with a light is inserted through the anus into the rectum and, further, into other lower parts of the colon, through which the intestine is examined from the inside in order to detect such possible causes of fecal incontinence as inflammation, tumors, scars.

  How is fecal incontinence treated?

  • food, diet, diet
  • medicines
  • pelvic floor exercises
  • bowel training
  • surgery
  • electrical stimulation.

  food, diet, diet

  • Get the right amount of protein. Many patients cellulose(other name vegetable dietary fiber) increases stool volume, making it softer and better manageable. Fiber can help with diarrhea and constipation. Fiber is found in fruits, vegetables, whole grains, and beans. Fiber supplements are sold in pharmacies and health food stores. Fiber foods are another versatile way to treat fecal incontinence. A normal diet should include 20 to 30 grams of fiber per day. Fiber should be added gradually to avoid flatulence.
  • Drink plenty. Eight 250-gram glasses of fluid a day can help prevent constipation. Water is a good choice. Drinks containing caffeine, alcohol, milk, or carbon dioxide should be avoided if they cause diarrhea.

  Prolonged diarrhea can become an obstacle to the human body getting enough vitamins and minerals. The doctor may recommend vitamin supplements to help with this problem and provide information about what changes in food, diet, or nutrition may improve the patient's condition.

  • dairy products such as milk, cheese and ice cream
  • drinks and foods containing caffeine
  • smoked and processed meats such as sausages, hams, turkeys
  • spicy food
  • alcoholic drinks
  • fruits such as apples, peaches and pears
  • fats and fatty foods
  • sweeteners, including sorbitol, xylitol, mannitol, fructose, used in diet drinks and sugar-free chewing gum and candies.

  Fecal incontinence in adults and children: causes, diagnostic methods and methods of treatment, recommendations

  Fecal incontinence is one of the serious problems. It is characterized by spontaneous excretion of feces. It can occur in both adults and children.

  What causes this phenomenon and is it possible to cure the disease?

  Description of the pathological process

  Fecal incontinence or encopresis in adults is a pathological phenomenon that occurs as a result of loss of control over the excretory process.

  The disease is so called when there is a problem with emptying the intestinal tract, a person loses the ability to hold feces inside himself. Because of this, there is a leak not only of the liquid mass, but also of the solid.

  In 70 percent of all cases, this process is a symptom of various disorders in babies from the age of five. Often before this, the child has a chronic stool retention.

  Most often, the disease is diagnosed in men.

  There is also an opinion that fecal incontinence in adults is a sign of impending old age. Many believe that this disease is only an senile disease. But the situation looks a little different.

  About 50 percent of patients are people between the ages of 40 and 60. But the disease is also directly related to old age.

  The reasons

  Many patients are interested in the question of why fecal incontinence occurs in an adult and a child? What reasons can contribute to the development of such a phenomenon? This pathology is always secondary.

  Causes of fecal incontinence in the elderly, adults and children can be hidden in:

  • constant diarrhea. Diarrhea is considered the most harmless cause of this disease. Due to the fact that the stool acquires a liquefied character, it is very difficult to keep it in the rectum. Diarrhea acts as a temporary factor for encopresis. After the symptom is eliminated, everything returns to normal;
  • prolonged constipation. As a result of the accumulation of solid masses, the intestinal walls begin to stretch, and the sphincter relaxes. Because of this, the urge to empty the digestive canal is weakened;
  • injury to muscle structures or weakening of their tone. Damage to the muscles in the sphincter occurs due to trauma of the domestic type or surgical intervention. Most often observed fecal incontinence after hemorrhoid surgery;
  • innervation difficulties. There are two types of disturbance in the conduction of impulses. The first option is in the nerve endings of the two sections of the sphincter, when the processes of relaxation and contraction are impaired. Another type is based on problems in the cerebral cortex or on the way to it. Then the person does not feel the urge to empty, thereby skipping it;
  • scarring of the rectum. This condition is accompanied by a decrease in the elasticity of the intestinal walls. As a result, encopresis occurs. The cause of the phenomenon is inflammation, surgery on the intestine, exposure to radiation;
  • enlargement of hemorrhoids. Swollen bumps do not allow the muscular apparatus in the anus to fully close;
  • problems with muscle structures in the pelvis. This includes fecal incontinence after childbirth, when muscle structures have reduced strength. The likelihood of manifestation of pathology increases in those who have experienced tears or an incision in the perineum during childbirth.

  Fecal incontinence in the elderly is the weakening of muscle fibers and loss of elasticity. Some patients experience fecal incontinence after a stroke.

  In contrast to the senile uncontrolled excretion of bowel movements in children, everything happens for other reasons. First of all, it should be noted that in babies before reaching 4-5 years, such a process is quite normal. Often it is accompanied by enuresis and has a physiological character. Gradually, with age, the child acquires skills, and is able to hold feces or urine.

  This happens in children and for psychological reasons. Often, babies cannot go to the toilet outside the home, as this causes them discomfort. If you do not visit the toilet for a long time, the process may occur spontaneously.

  Separately, it should be said about children from dysfunctional families. Fecal incontinence can occur in the absence of the required skills. The parents do not supervise the child. This phenomenon may be accompanied by a permanent disorder, as a result of which they do not recognize the smell of feces and do not react in any way to the discharge.

  Diagnosis

  With stool incontinence, it is not so difficult to make a diagnosis. If a patient has fecal incontinence, the causes should be recognized as soon as possible and then treated with therapy.

  Based on the person's complaints, the doctor prescribes an examination, it includes:

  • anorectal manometry. This technique is performed to determine the level of susceptibility of the rectum. Also, an assessment is made of the force of compression of the sphincter and its innervation;
  • magnetic resonance imaging. This method helps to take pictures of the muscular apparatus of the anorectal zone with high accuracy;
  • ultrasound diagnosis of the transrectal view. Performed to assess the external structure of muscle strictures;
  • proctography. This technique refers to X-ray examination. It allows you to examine the rectum when there are feces;
  • sigmoidoscopy. The examination consists in a visual inspection of the intestinal walls for the presence of scars and tumors;
  • electromyography. This method makes it possible to assess the state of the neuromuscular apparatus in the pelvic floor.

  After identifying the cause, the attending physician prescribes treatment for encopresis based on the age of the patient and the characteristics of the disease.

  Therapeutic measures

  How to treat encopresis at home? Treatment of encopresis is carried out based on the cause of the development of the disease.

  Dieting

  This technique for fecal incontinence is used only when the cause is constipation or diarrhea.

  1. It is necessary to consume those foods that include a high content of fiber. Their impact is aimed at normalizing the consistency and manageability of feces, preventing the formation of constipation. But it is necessary to increase their content in the diet gradually, since a large accumulation of gases in the intestines is possible.
  2. Drink plenty of fluids. It is purified water, not juices and tea. At the same time, fruit and vegetable juices should be taken with extreme caution, as this can lead to diarrhea.
  3. A special diary should be kept, which will indicate what the patient ate. With the development of pathology, he will be able to understand which product leads to a change in the consistency of feces, and exclude it from the diet.
  4. Fecal incontinence in adults over 60 years of age is treated with a folk remedy. To do this, use vaseline oil. It should be taken two tablespoons up to two times a day. This process helps to soften the feces and promotes their excretion.

  What diet to follow, the doctor decides with the patient on an individual basis.

  Conservative treatment

  What to do if there is fecal incontinence in women and men? In some cases, the use of medications is required.

  Treatment for fecal incontinence is:

  • the use of laxative tablets for constipation;
  • the use of antidiarrheal drugs for diarrhea;
  • the use of medications that reduce the amount of water in the bowel movements.

  Along with drug therapy, the patient needs to adhere to some recommendations:

  • compliance with the regime. If the patient has constipation, then it is necessary to establish the process of emptying. It is necessary to mentally ask the body to cleanse the body of feces at a certain time;
  • performing physical exercises. They will help strengthen the muscle structures of the pelvic floor and sphincter. This technique will help when there is gas incontinence after childbirth. An excellent exercise is to relax and contract the sphincter. It is enough to carry out this procedure up to three times a day for a month, and the problem will disappear by itself;
  • conducting physiotherapy. Electrical stimulation has an excellent effect;
  • performance of water procedures. You need to take baths or go to the pool more often. This will strengthen the muscle structures.

  Surgery

  If other methods do not help to eliminate the problem, then the doctor resorts to surgical intervention.

  There are several types of surgery called:

  • straight sphincter. It is based on strengthening the muscle tissues of the anus with a strong connection with the rectum. It is used in cases where the muscles are affected due to damage or atrophy;
  • artificial sphincter. It is installed around a real sphincter. The device is a special cuff that regulates pressure and acts as a pump;
  • colostomy. Most often used after surgery on the digestive canal. This procedure involves the connection of the large intestine with the anterior abdominal wall. When the defecation process takes place, the stool will be collected in a bag.

  Which type of treatment to choose, it is up to the doctor to decide based on age, the cause of the disease and the course.

  Fecal incontinence is called encopresis in medicine. In some cases, this process is physiological and goes away with time. In other situations, why the pathology occurs can only be explained by the doctor on an individual basis.

  But whatever becomes the decisive factor, you need to follow some tips:

  1. When leaving the house, be sure to visit the toilet. It is necessary to empty the intestinal canal by any means.
  2. If the patient is going somewhere far away, then you need to take care of a change of underwear. If necessary, take wet wipes. They will help eliminate the remnants of bowel movements.
  3. Take pills that help reduce the intensity of gas and bowel odors. They can be purchased at a pharmacy without a doctor's prescription.
  4. Get the treatment prescribed by the doctor.

  Fecal incontinence can lead not only to health problems, but also to being in society. If the first signs of uncontrollable stool exit occur, you should seek help from a specialist and determine the cause of the disease.

Fecal incontinence, or encopresis, is a disease of the sphincter muscles in which a person completely loses the ability to control the ability to defecate. Most often this phenomenon occurs in young children. At a more adult age, encopresis indicates serious deviations and pathologies in the functioning of the body.

This problem is not dangerous for human life, but significantly reduces its quality. The causes of the development of the disease are conditionally divided into organic and psychogenic.

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Description

The process of defecation is controlled by a special center, which is located in the medulla oblongata of the brain. The act of emptying consists in the downward influence of the brain on the spinal center of the sacral spine. As a result, the muscles of the external sphincter relax, and the diaphragm and abdominal muscles contract. Thus, a person can control the process of defecation in situations where it is undesirable or inappropriate.

According to statistics, fecal incontinence is most common in children 4-5 years old. Among the adult population, only 5% of patients are affected by the disease. Encopresis in this case is accompanied by disturbances in the work of the intestine. It is more common in women who have had a difficult birth. The disease acquires particular relevance in old age, when degenerative processes associated with natural aging begin to occur in the body. Therefore, in older people, the disease is much more common than in women and men under 65 years of age.

As an independent disease, encopresis is diagnosed extremely rarely and only in the presence of pathologies of the pelvic organs. In other cases, the problem is psychological or organic in nature. Most often accompanied by another violation - urinary incontinence.

Reasons for the development of pathology

Conventionally, the causes of encopresis development are divided into organic and psychogenic. The first group includes factors that appeared as a result of injury or under the influence of certain diseases, the second - exclusively associated with disorders in the brain region that is responsible for the defecation process.



organic incontinence

This type of disease is more common in adults. Occurs for the following reasons:

• diseases of the rectum - hemorrhoids, chronic constipation or diarrhea;
• weakening of the muscles of the external sphincter;
• improper functioning of the nerve endings of the external part of the anus;
• violation of the elasticity of the muscles of the rectum;
• functional disorders of the muscles and nerves of the pelvic floor.

Each of the reasons has its own characteristics.



Diseases of the rectum

With the development of hemorrhoids, the nodes are located outside the entrance to the anus. They prevent the complete closure of the anus. And this, in turn, leads to a slight leakage of mucus and liquid feces out.

Constipation also provokes the development of encopresis. The most dangerous is its chronic form. If a large amount of feces constantly accumulates in the rectum, then gradually this leads to stretching of the muscles of the anus. As a result, it ceases to cope with its basic functions. And if the solid feces are held back by the sphincter, then the liquid stool, which is located behind the solid masses, begins to gradually flow out.

If a person develops diarrhea, it can be difficult to contain even if the sphincter muscles are functioning properly. And if there is any violation or deviation, the expiration of feces occurs involuntarily.

Weakness of the anal sphincter

If the muscles of one of the sphincters - external or internal - are injured, they cease to cope with their functions. Depending on the severity of the disease, the sphincter loses its ability to close completely, and the feces flow out. In most cases, muscle damage occurs as a result of childbirth - cutting the perineum or using forceps to remove the baby. The disease is most often diagnosed in women after childbirth.

Weakening of nerve endings

Under the mucous membrane of the rectum are not only muscles and blood vessels, but also many nerve endings. They are able to respond to the amount of feces in the passage, thereby regulating bowel movements. During normal functioning of the nervous system, the anal sphincter is almost always in a compressed state, relaxing only during defecation.

If the nerves located under the mucous membrane do not work properly, the person does not feel the urge to defecate and cannot go to the toilet in time. Most often, such disorders occur in diabetes, multiple sclerosis and stroke.

Decreased elasticity of the rectal muscles

The rectum has rather elastic muscles that allow it to stretch to a large size and hold impressive volumes of stool until the next bowel movement. But due to operations or certain diseases - colitis, Crohn's disease - the elasticity and ability of the connective tissue to stretch decreases.

As a result, the intestinal walls are unable to retain feces, leading to encopresis.

Psychogenic encopresis

In this case, incontinence is caused by violations of the reflexes responsible for the defecation process. Most often this occurs against the background of mental illness:

• schizophrenia and dementia;
• manic-depressive states;
• epilepsy;
• personality disorders;
• emotional experiences.

If a person has symptoms of one of the above ailments, the logical chain of transmission of commands through the nerves for the act of defecation is disrupted. The exclusion of one of the components of this chain leads to the fact that the process of containing feces is violated - partially or completely.

Diagnostic measures

In order to make a diagnosis of encopresis, the doctor prescribes a set of studies. The patient must take a blood test, feces and urine. Further instrumental methods allow you to confirm or refute the initial diagnosis, as well as to choose a rational treatment.

The main methods for establishing encopresis are:

1. 1. Anorectal manometry. This method consists in determining the degree of compression and stretching of the sphincter, as well as the sensitivity of the nerve endings.
2. 2. MRI - is used as the main research method. Allows you to see the examined part of the intestine and determine in which place the violation is located.
3. 3. Proctography allows you to determine the capacity of the intestine. Also, using this method, the movement of feces through the intestine is determined, the time of its filling is determined after the ingestion of feces from the sigmoid colon until the moment it is excreted by the sphincter.
4. 4. Rectal ultrasound. The procedure is completely painless for the patient. Allows you to determine the condition of the rectum and sphincter in the entrance area using ultrasound. It is performed by inserting a special sensor into the anus.
5. 5. Sigmoidoscopy - the introduction of a special tube into the anus through which the examination is carried out. The procedure allows you to identify the presence of scars, adhesions or inflammatory processes.

For each individual patient, an individual method of additional diagnostics is selected based on the obtained analysis data.

Therapy

The basis of the treatment of the disease is drug therapy and nutritional correction. Often the patient is prescribed physiotherapy exercises. In rare cases, surgery is recommended.

In order to eliminate the problem, you should eat as often as possible - up to 5 times a day. Portions should be small. It is necessary to remove from the daily diet:

• bread and other pastries;
• pasta;
• raw vegetables and fruits;
• smoked meats;
• cereals;
• tea and coffee;
• citrus and bananas.

Include in the diet you need mucous soups, dairy products, boiled vegetables, dried fruits. This will help prevent the development of constipation.

Medical treatment is to eliminate the root cause of the pathology. Most often, doctors try to correct two types of defecation disorders:

• Diarrhea - in this case, drugs are used to increase fecal mass (Metamucil). Means can be prescribed that will reduce the number of urges to defecate - Imodium, Diara.
• Constipation - in this case, the patient is prescribed drugs that soften the stones (Bisacodyl).

If fecal incontinence is mental in nature, then the underlying disease should be treated. In this case, self-treatment at home will only hurt.




Surgical intervention

If medical treatment fails, your doctor may recommend surgery. Most often, this method is used by the elderly as the only possible one.

In most cases, the patient is performed:

• sphincteroplasty - the injured sphincter muscles are connected;
• sphincterolevatoroplasty - normalization of the functions of the anus;
• sphincterogluteoplasty - restoration of sphincter tissue by implanting materials from the gluteal muscle.

Often the patient requires a colostomy - an operation in which part of the colon is brought out through the abdomen. This is done so that the feces come out through it.

Folk methods

It is impossible to cure the disease with folk remedies, but in combination with drug therapy, it turns out to be effective.

Encoporesis or fecal incontinence is a disorder in which the patient loses the ability to control the process of defecation. This condition does not threaten human life, but significantly worsens its quality. In most cases, the appearance of encoporesis in adults is associated with organic pathologies, including tumor processes and injuries. According to statistics, this disease is more often diagnosed in men.

What is fecal incontinence

Fecal incontinence until recently was considered a common condition in the elderly in old age. However, upon closer examination of the problem, it turned out that they suffer from this disease even at a younger age.

Interesting fact! About 50% of patients with this diagnosis are men and women of middle age (from 45 years old). Less than a third of patients with encoporesis are elderly (75 years or older).

By this concept, doctors understand the inability to restrain the urge to empty the intestines until the right moment comes - going to the toilet. In this case, involuntary leakage of feces occurs, regardless of its consistency.

The mechanism of the development of the disease consists in a violation of the coordinated functioning of the sphincter and pelvic floor muscles, which hold stool in the rectum and keep the intestines in good shape. Normally, this occurs due to the activity of the autonomic nervous system, that is, the process of defecation without a conscious effect on the tone of the sphincter. It remains in a tense (closed) state during sleep and wakefulness. The average pressure in this area in men is slightly higher than in women, and the average indicators of this value are 50-120 mm Hg.

Stimulation of defecation occurs due to irritation of mechanoreceptors in the rectum. It occurs due to the filling of this section of the intestine with feces. In response to irritation, a person has a Valsalva reflex, in which he feels the need to take a position suitable for emptying the intestines (squatting), after which he begins to contract the muscles of the anterior abdominal wall. At the same time, the rectum reflexively contracts, pushing the feces out.

If it is impossible to perform an act of defecation in a healthy person, the person arbitrarily contracts the pubic-rectal muscles and the anal sphincter. At the same time, the rectal ampulla expands, the urge to empty is weakened. With encoporesis in adults, at one of the stages described, a failure occurs, and feces freely exit the anus.

Types of fecal incontinence

There are several varieties of encoporesis in adult patients, depending on how exactly the stool leaks:

1. Permanent (regular) incontinence without the urge to defecate. Most often, this type of disease occurs in children and elderly people who are in serious condition.
2. Incontinence, in which, shortly before the leakage of feces, the patient feels the urge to defecate, but there is no way to delay this process.
3. Partial incontinence, in which defecation occurs with certain loads - coughing, sneezing, lifting weights. In such situations, urinary and fecal incontinence is often observed.

Separately, age-related fecal incontinence is distinguished, which is diagnosed in elderly people due to degenerative processes in the body.

The classification of the disease also includes the stages of progression of encoporesis. There are three in total:

Each type of encoporesis has its own characteristics. To begin the treatment of this condition, the doctor will have to determine the causes of the pathology.

Causes of encoporesis in adults

Various situations can provoke the development of fecal incontinence. In adults, the main causes of the appearance of pathology are associated with diseases and dysfunctions of the pelvic organs, pelvic floor, rectum and other parts of the intestine.

The most common causes of incontinence in middle-aged and older patients are as follows:

1. Constipation. If a person's stool occurs no more than 3 times a week, feces accumulate in the rectum, resulting in stretching and weakening of the sphincter muscles. The result of the process is a weakening of the holding capacity of the rectum.

1. Traumatic changes in the sphincter muscles (external or internal). Occurs as a result of trauma or after surgery on the rectum. As a result of such changes, muscle tone is completely or partially lost, and retention of fecal masses becomes problematic or impossible.

1. Failure of nerve endings and receptors in the rectum, as a result of which the patient does not feel that the rectum is full, or the body loses the ability to regulate the degree of tension of the internal and external sphincters. Childbirth, diseases and injuries of the central nervous system can lead to such problems. Often such disorders occur after a stroke or traumatic brain injury. Very often in such patients there is simultaneous incontinence of urine and feces.
2. Decrease in the tone of the muscles of the rectum as a result of the formation of scars on it and a partial loss of elasticity of the walls of the organ. Such situations arise after rectal surgery, radiation therapy, ulcerative colitis and Crohn's disease.
3. Dysfunction of the pelvic floor muscles due to impaired nerve conduction or muscle failure. These can be disorders such as rectocele, rectal prolapse, postpartum weakening of the pelvic floor muscles in women. A common combination is episiotomy and fecal incontinence. Pathology is detected immediately after childbirth, which required dissection of the perineum, or after a few years.

1. Hemorrhoids often cause partial fecal incontinence. Hemorrhoids, especially if they are located under the skin around the anal sphincter, do not allow it to close completely. As a result, fecal leakage occurs. Over time, with a long and chronic course of the disease, progressive prolapse of hemorrhoids, a decrease in the tone of the sphincter increases, and the symptoms of incontinence intensify.

Interesting fact! Experts have found that habitual holding back of stool can weaken the anal sphincter and lead to stretching of the rectal ampulla. If you put off going to the toilet too often and endure for several hours, over time you may encounter fecal incontinence.

A large proportion of diseases are due to mental and psychological disorders. Loss of control over defecation occurs in patients with various forms of psychosis, schizophrenia, neurosis. Sudden leakage of feces can occur during a panic attack or hysteria, an epileptic attack. Lose control over bowel movements and patients with senile dementia.

Diagnostics

To find ways to treat fecal incontinence, the doctor will need to find out a lot of things. To begin with, a survey is conducted, during which the doctor finds out the features of the condition:

• in what situation does fecal leakage occur;
• how long it is observed and with what frequency;
• whether or not an urge to defecate is felt before a leak occurs;
• stool of what consistency is not retained;
• the amount of stool passed, with or without gas it passes.

Also, the specialist needs to know if there have been strong emotional upheavals or traumas recently, whether there is confusion of thoughts or disorientation in space, what drugs he takes, what his diet consists of, whether there are bad habits and whether incontinence is accompanied by additional symptoms.

To establish the exact picture and causes of incontinence, a set of diagnostic instrumental studies is used:

• anorectal manometry to measure the sensitivity and contractility of the anal sphincter;
• MRI of the pelvis to visualize the condition of the muscles of the pelvic floor and anal sphincters;
• defectography (proctography) to determine the amount of feces that the rectum is able to hold, and to identify the features of the process of bowel movement;
• electromyography to study the correct functioning of the nerves responsible for the contractility of the anal sphincter muscles;
• sigmoidoscopy and ultrasound of the rectum, with the help of which it is possible to detect deviations in the structure of this section of the intestine, as well as to detect pathological neoplasms (scars, tumors, polyps, etc.).

Additionally, patients are prescribed complex laboratory diagnostics: blood, feces, urine tests (general and biochemical). Only after that the doctor decides how and how to treat encoporesis.

Important! To eliminate fecal incontinence, it is first necessary to eliminate the diseases that caused the weakening of the muscles of the anal sphincter and pelvic floor, and get rid of comorbidities.

Methods for the treatment of fecal incontinence

In adult patients, the treatment of fecal incontinence requires an integrated approach. The patient is advised to review the diet, adjust physical activity, practice regular pelvic floor muscle training, take special medications, and refuse some drugs altogether. It is used to eliminate this problem and surgical intervention.

Medical therapy

Drug therapy is used mainly for incontinence, which occurs against the background of diarrhea. Several groups of drugs are used:

• anticholinergics, which include atropine and belladonna - to reduce intestinal secretion and slow down peristalsis;
• drugs with opium derivatives (Codeine and painkillers) or diphenoxylate - to increase the tone of the intestinal muscles and reduce peristalsis;
• drugs that reduce the amount of water in the stool - Kaopektat, Metamucil, Polysorb and others.

A good antidiarrheal effect is also exerted by classical drugs - Loperamide, Imodium. They help to get rid of the manifestations of encoporesis injections of Prozerin, the drug Strikhin. It will also be useful to take vitamins (ATP, group B and others).

Important! To restore the stool, patients with encoporesis are not recommended to take antacids, as well as drugs that can cause diarrhea.

With mental and psychological problems, the patient is shown sedatives, sedatives and tranquilizers, which help control behavior. They are released only by prescription.

Diet

Doctors call diet therapy the basis of therapeutic measures for the insolvency of the anal sphincter. Without adherence to certain nutritional standards, treatment will be ineffective. The main tasks of the diet:

• stool restoration (exclusion of diarrhea and constipation);
• reduction in stool volume;
• normalization of intestinal peristalsis.

The primary task is to exclude from the menu products that provoke softening of the stool. These include sugar substitutes (sorbitol, xylitol, and fructose), dairy products, especially whole milk and cheeses, nutmeg, alcoholic beverages, and coffee. It is advisable to minimize or completely eliminate hot spices, lard, fatty meats, citrus fruits from the diet. You should also refrain from smoking.

Important! Patients are advised to keep a diary in which information about the foods eaten, the time of their intake and the volume of servings should be recorded. It should also be noted at what moments incontinence occurs. This will help to eliminate foods that irritate the intestines from the menu.

The basis of the diet should be cereals, fresh fruits and vegetables, whole grain bread or wholemeal flour. They contain a lot of fiber, which contributes to the thickening of feces. Sour-milk drinks without additives will also be useful. With a lack of fiber, bran, flakes from whole wheat grains are included in the diet. It is desirable to take food often and little by little, up to 5-6 times a day. The intervals between meals should be equal.

exercise therapy

A complex of special gymnastics (Kegle exercises) is used to strengthen the muscles of the sphincter and the pelvic floor. It includes the following exercises:

• contraction and relaxation of the anal sphincter - repeat 50-100 times a day;
• retraction and protrusion of the abdomen - 50-80 repetitions per day;
• tension of the pelvic muscles inwards and upwards in a cross-legged sitting position.

Such exercises equally well strengthen the pelvic muscles in men and women. You can perform them in several variations: quickly alternate contraction and relaxation, hold the muscles in tension for 5-15 seconds and relax for 5-7 seconds, and so on. How to do physical therapy according to Kegel is shown in the video:

At the initial stage, the doctor can connect special sensors to the patient's body, which will indicate which muscles are included in the work during the exercises. So you will be able to understand how to do gymnastics correctly.

Patients who are recovering from a stroke are also shown a set of exercise therapy exercises, but in addition to the techniques described above, attention is paid to the development of fine motor skills. It will be useful for them to squeeze or roll small balls in their palms, to sculpt, to fold mosaics from medium-sized elements. All this will allow you to quickly restore neural connections in the brain and get rid of the unpleasant consequences of the disease.

Important! Gymnastics does not give instant results. The effect becomes noticeable after a few weeks from the start of daily training, and is fixed after 3-6 months.

Surgery

Surgical intervention is used when the previously described methods are ineffective. Such treatment works well after surgery on the rectum, which gave complications in the form of encoporesis, after injuries (including postpartum) and incontinence caused by a tumor process in the rectum.

To eliminate the insolvency of the anal sphincter, apply:

• Sphincteroplasty, during which the sphincter is reconstructed. This method is used for injuries of the muscle ring, its complete or partial rupture.
• A "straight sphincter" operation, during which the sphincter muscles are more tightly attached to the anus.
• Installation of an artificial sphincter, consisting of a cuff covering the anus, and a pump that supplies air to the cuff. This device keeps the anus closed, and if necessary to empty the intestines, the patient deflates the cuff (releases air from it).

• Colostomy, during which the large intestine is cut off and brought to the opening in the anterior abdominal wall. Feces are collected in a special bag - a colostomy.

The type of surgical intervention that will be applied to the patient is selected based on the causes of encoporesis. Only the attending physician can choose how to treat the disease.

To cope with the difficulties in everyday life that inevitably arise in patients with encoporesis, the following tips will help:

1. Try to empty your bowels before leaving the house.
2. It is worth planning walks and visits 1-2 hours after the main meal or later.
3. Before leaving the house, make sure that you have wet wipes and a change of clothes in your bag.
4. If the risk of fecal leakage is high, it makes sense to use disposable underwear instead of regular underwear.
5. When you are away from home, the first thing to do is find out the location of the bathroom.
6. Use special underwear or diapers.

Note! In pharmacies, you can buy drugs, the use of which allows you to weaken the specific smell of feces and gases.

The failure of the anal sphincter is an extremely unpleasant disease, which many patients prefer to remain silent about. The first step on the road to recovery is seeing a doctor. You can come with such a problem to a therapist or proctologist. If incontinence occurs after childbirth in women, they should consult a gynecologist. The sooner you pay attention to the pathology and take measures to eliminate it, the higher the chance to restore the functions of the anal sphincter, or at least prevent further progress of the disease.

Trying to fix the situation with folk remedies is not worth it. Most of them are ineffective, and sometimes downright dangerous. Even if there is a desire to try to improve the condition through folk remedies, it is recommended to start taking them after consulting with your doctor.

Normally, the muscles of the anus can retain the gaseous contents of the intestines and fecal masses of various consistencies during physical exertion, changes in body position, coughing, sneezing until the right moment. The absence or loss of the ability to control the act of defecation (the excretion of feces) is called encopresis. Pathology can be congenital or acquired. It is diagnosed more often in females. In older people, fecal incontinence is usually combined with urinary incontinence.

The principle of the act of defecation

People are able to suppress the urge to defecate from about 2 years of age. Bowel movements are controlled by the CNS.

Reaching the anus, the feces usually already have the required density and volume (average 200 ml). The sphincter muscles hold the calculi, allowing bowel movements to be carried out exactly at the right moment.

The muscles of the abdominal cavity and pelvic floor are also involved in the process of defecation.

Varieties

Encopresis comes in varying degrees of severity.

There are 3 degrees of disorder of the act of defecation:

• difficulties with holding gases;
• incontinence of rarefied feces and gases;
• the inability to control the emptying of any consistency.

When the first difficulties appear, you should immediately seek medical help.

Symptom of diseases

The causes of problems in the implementation of the act of defecation can be congenital, occur as a complication of diseases or become a consequence of injuries (brain, anus).

In the first case, pathology occurs when:

• defect of the anal canal;
• developmental disorders of the brain and spinal cord.

As a symptom of diseases, encopresis is manifested in constipation, rectal cancer, diarrhea, hemorrhoids.

Sparse fecal masses rapidly enter the rectum. They are more difficult to hold than formed calculi, so encopresis is a common addition to the disorder.

Hemorrhoids that have arisen around the anal area make it difficult for the obturator function of the sphincter. Part of the feces will seep through the anus.

Constipation

A certain volume of stones of increased hardness is collected in the rectum. Feces that are more liquid in consistency accumulate behind compacted formations and pass through them.

In the later stages of the malignant process in men and women, one of the symptoms is fecal incontinence. Faeces may become dark in color (due to the admixture of blood). The emptying procedure becomes painful.

A sign of impaired functioning of the muscles and nerves of the anal region

Pathology may be the result of a violation of the tone of the muscles of the sphincter and rectum, nerve failure, dysfunction of the pelvic floor.

Decreased muscle tone of the rectum and sphincter

Weakening or overstretching of the sphincter muscles impairs the ability to retain stool.

Inflammatory processes in the intestines, operations in the anus, radiotherapy can provoke the formation of scars in the rectum. This reduces its elasticity. The rectum stretches worse and loses the ability to control stools, which leads to encopresis.

Nerve failure

If the nerve endings located in the area of ​​the sphincter and rectum do not work correctly, then the muscles will not contract and relax as necessary, and the person will no longer feel the urge to empty the intestines.

Such a condition may be the result of a habit of not paying attention to the urge to defecate, as well as certain diseases (multiple sclerosis, diabetes mellitus).

Pelvic floor dysfunctions

Disruption of the muscles, ligaments, or nerves of the pelvic floor is a factor that causes fecal incontinence.

Sometimes childbirth, which took place with trauma to the uterus, bladder, becomes a factor provoking encopresis. Dysfunction begins to bother immediately or years later.

Manifestation of neurological disorders

Fecal incontinence may be one of the symptoms of neurological disorders: manic-depressive or catonic syndrome, schizophrenia, psychosis. In this case, a change in the functioning of the central nervous system becomes the cause of the disorder.

With age-related disorders of the nervous system, fecal incontinence in the elderly is often associated.

Diagnostics

Dysfunction is established on the basis of symptoms, the performance of diagnostic studies.

• defecography - an x-ray examination that informs about the ability of the rectum to carry out its functions;
• anorectal manometry - to study pressure, response to nerve signals and the work of the sphincter muscles, as well as to check the susceptibility of the rectum;
• magnetic resonance imaging - is selected to obtain images of the sphincter muscles;
• transrectal ultrasound - to study the condition of the muscles of the anus and rectum;
• sigmoidoscopy - examination of the rectum using a special tube. Helps to identify inflammatory processes, cicatricial changes, neoplasms;
• electromyography of the pelvic floor and rectum - clarifies how the nerves that regulate the work of these muscles function.

Only by finding out the cause of encopresis, the specialist will be able to prescribe an effective treatment.

Principles of therapy

The basis of treatment is dietary modification, drug therapy. Exercises that strengthen the pelvic floor muscles may be prescribed. In some cases, only surgery is effective.

Diet correction

To eliminate dysfunction, it is important to normalize the nature of the stool. You need to eat 4-5 times a day. Portions should be small.

To be excluded from the menu:

• bread;
• pasta;
• raw vegetables and fruits;
• cereals (millet, semolina, rice, barley);
• coffee;
• smoked meats;
• cocoa;
• chocolate products;
• garlic;
• canned food;
• citrus;
• bananas.

It is important to drink enough liquid (up to 2 liters per day).

The diet should include:

• mucous soups;
• boiled vegetables;
• fermented milk products (yogurt, kefir);
• dried fruits (dried apricots, figs, prunes).

Medical treatment

With dysfunction of the gastrointestinal tract, therapy is aimed at eliminating the type of pathology.

Most often, 2 options for violation of defecation are corrected:

• diarrhea - prescribe drugs that increase the amount of fecal mass (Citrucel, Fiberlax, Metamucil). Diarrhea remedies can be prescribed that reduce the urge to empty the intestines and slow down peristalsis (Suprilol, Diara, Imodium);
• constipation - prescribe medications that soften stones and accelerate their evacuation. (Sodium picosulfate, Bisacodyl).

With neurological disorders, the treatment of the underlying disease is performed.

Performing special gymnastics can strengthen the muscles of the pelvic floor.

Effective exercises will be:

• rapid contraction and relaxation of the pelvic muscles - 50-100 times a day;
• muscle tension as when urinating (men) or defecation (women) - 20-50 times a day.

Gymnastics can be performed in any position of the body. She is invisible to others.

neuromodulation

Neuromodulation (electrical stimulation, electrical stimulation) is performed with special electrodes. They are placed on the nerve endings of the rectum and anus and are regularly activated. The duration of one session is 10-20 minutes. The course of treatment is 2 weeks. Reappointment of neuromodulation is possible after 3 months.

Surgery

If medical therapy or encopresis is ineffective due to damage or anatomical disorders of the pelvic floor or anal sphincter, surgical correction is performed.

It could be:

• sphincteroplasty (connection of injured sphincter muscles);
• sphincterolevatoroplasty (normalization of the functions of the anus);
• sphincterogluteoplasty (restoration of the sphincter using tissue taken from the gluteus maximus muscle).

Sometimes a colostomy may be necessary. The operation consists in removing part of the colon through an opening in the abdomen and forming a colostomy to remove gases, feces and mucus.

Treatment with folk remedies

Traditional medicine recipes can be used as part of the complex treatment of fecal incontinence.

Effective recipes are:

• infusion of calamus rhizomes - 20 g of dried and chopped berries should be poured with 200 ml of boiling water. It is necessary to insist within 1 hour. Drink 1 tsp. after every meal;
• fresh berries or rowan juice - consume 1 tsp. berries or juice after meals 3 times a day;
• honey - eat 10 g of honey 3 times a day.

Contraindications for such therapy are gastrointestinal diseases in the acute stage, allergic reactions.

Constant contact of the skin of the anal area with fecal matter can cause irritation. Necessary:

• wash and gently dry the anus after each case of encopresis;
• apply a cream that forms a moisture-protecting film on the skin (Relief, Aurobin, Fleming);
• use daily pads;
• refuse synthetic, too tight underwear, as well as thong panties.

Encopresis is a problem that can be a symptom of serious pathologies. Finding out the cause of fecal incontinence in men and women in the process of diagnosis allows you to choose the best treatment option. Therapy can be medical or surgical. Surgery is rarely used. Elimination of the disorder allows you to normalize the quality of life.

Parents of babies 4-10 years old sometimes face such a phenomenon as fecal incontinence (encopresis). The flow of bowel movements on underwear after the child has mastered the skill of using the toilet is observed in 1.5% of children, often accompanied by enuresis (urinary incontinence). Violation of the rectal sphincter is more often detected in boys, which still has no explanation.

Some babies suffer from fecal incontinence even after they have mastered the potty.

What should be considered the norm, and what - pathology?

Involuntary defecation is typical for newborn babies, whose body is not yet able to control the work of the digestive organs. However, by the age of 3, the cycle of conditioned reflexes is established, the kids already know how to recognize body signals and sit on the potty in time.

The urge to go to the toilet arises as a result of a complex of reactions. Feces in the rectum accumulate and put pressure on the sphincter. With a strong impact, the impulse goes to the brain, from where the command returns through the spinal canal to empty the intestines or retain feces (based on the situation). Their conscious evacuation involves the muscles of the peritoneum, rectum and nervous system.

Encopresis occurs in children 4-6 years old when a failure occurs in one of the sections of the physiological circuit. Sometimes it is secondary (the child has learned to go to the toilet as expected, but under the influence of certain reasons, stone smearing occurs).

There are known cases of incontinence in adolescents, young people and the older generation. Each of them requires its own approach and correction.

Age features

Depending on age and nutritional habits, the frequency of bowel movements in children varies. What in some cases is taken as the norm, in others speaks of a problem:

• Up to 6 months, stools in infants up to 6 times a day are considered the norm. More frequent urges indicate diarrhea, there is no question of incontinence - the baby does not control the sphincter.

• From six months to a year, the child's muscles are strengthened, the intestines are emptied 2 times a day. Toddlers do not realize the importance of hygiene, they can continue to stain the laundry.
• The sphincter muscles of a 1.5-4 year old child have already grown stronger, he is able to control the process of defecation and ask for a potty in time. The exception is stress and psychological trauma, as a result of which the baby forgets about it.
• Between the ages of 4 and 8, fecal incontinence in children is far from normal. It indicates psychological or physical disorders. It is important to undergo an examination, identify and eliminate the cause.

Causes of encopresis

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Experts identify two causes of encopresis in children: psychological and physiological. For some people, it does not go away as they grow older (primary disorder). Others develop an indirect violation due to circumstances that caused severe stress (going to school, divorce of parents, deterioration of social, housing conditions, etc.). The causes of indirect violations are:

• excessive demands on the baby;
• forced potty training;
• fear of a potty or toilet;
• lack of affection in the family;
• inability to express emotions;
• inability to visit the toilet on time (in the garden, school, other place);
• unwillingness to attend a garden, school;
• unfavorable home situation, other factors.

What often precedes encopresis?

Encopresis is often preceded by constipation. The baby may be embarrassed to go to the toilet in a big way in an unusual environment (long trip, hike, strangers in the house) or the defecation process causes him pain. It often suppresses the urge, which eventually causes a reflex. Accumulating, fecal masses become denser and stretch the walls of the rectum. Reflexes are suppressed, and at an unexpected moment there is a spontaneous excretion of feces.

Stagnation of feces in the intestines can lead to poisoning of the body - "false diarrhea". In the second case, active fermentation begins in the upper intestines, and a liquid with a fetid odor descends to the sphincter, washing the compacted feces, and leaks out. Sometimes encopresis is the result of "bear disease" (irritable bowel syndrome), which arose as a result of unresolved problems and fears.

The opinion of psychologists about encopresis

When communicating with a child, a good psychologist can quickly identify the cause of the problem. Usually, these are difficult relationships with peers, quarrels and family troubles, because of which the baby is in constant tension. It is noted that more often boys and girls suffer from encopresis, whose parents do not pay due attention to them, are addicted to alcohol, use harsh methods of education.

The problem does not bypass hyperactive guys, prosperous families, where parents strive to create the best conditions for their children (we recommend reading:). It is not always possible to choose an effective therapy and cure the causes of fecal incontinence in a short time. Much depends on the perception of this problem by the elders, their readiness to meet the problems of the child.

Symptoms

Encopresis in children usually develops slowly, and parents do not always sound the alarm in time. An important "bell" is the remains of feces on underwear, it cannot be ignored. If the situation repeats, you should observe the child, his behavior and well-being.

Usually, children suffering from neurotic encopresis have irritability, poor appetite and mood. Show the baby to the doctor if the remnants of feces on the linen appear regularly.

The main symptoms of true encopresis

Depending on the causes of encopresis (physiological or psychological violation of bowel movements), the symptoms also differ. True encopresis (the main violation), as a rule, is accompanied by:

• stone smearing;
• enuresis (we recommend reading:);
• behavior outside the generally accepted norms;
• semi-open sphincter (examined by a doctor);
• a stench that cannot be hidden from the environment.

Symptoms of false encopresis

False encopresis in children (indirect violation) is confirmed by the following symptoms:

• alternating constipation and offensive diarrhea;
• cracks and redness near the anus;
• isolation of the child;
• hard stomach when examined by a doctor (palpation);
• pain in the navel;
• chronic accumulation of feces in the large intestine.

Fecal incontinence in a child is often accompanied by a tense family situation. Parents should not isolate the child from other family members, ignore the problem, scold him for soiled things, and ridicule him. This will lead to a deterioration in academic performance, the inner protest of the baby, who will ignore school and home duties, will become withdrawn and gloomy.

Letting go of the problem of fecal incontinence in children, believing that it can be "outgrown", should not be. The child grows up, he needs to adapt in society. Timely medical assistance will allow you to find out by what means you can treat incontinence and how to cope with stool smearing.

Diagnostic methods

First of all, the doctor differentiates true and false encopresis. All causes leading to constipation are considered, worms are excluded, additional studies (blood, feces, urine, abdominal ultrasound, colonoscopy) are prescribed to identify congenital pathologies. When a delicate problem cannot be solved for a long time, a biopsy of the rectal wall is connected, an analysis of motility.

Methods of treatment

If you suspect fecal incontinence in a child, they initially turn to a pediatrician. The doctor may prescribe tests, prescribe laxatives (for example, Dufalac) and enemas, which will clean the intestines and return the original size of the rectum (see also:). After examination and initial appointments, the pediatrician sends the child for a consultation with a neuropathologist and a gastroenterologist.

If the problem has affected a schoolchild, it is important to find a doctor who specializes in the treatment of encopresis and is ready to work with the child and his relatives. Treatment will be based on the following components:

• prevention of stool retention;
• establishing a regular bowel movement;
• restoration of control over the work of the intestine;
• reducing the tense psychological atmosphere in the family caused by encopresis.

Working with a psychologist

The first stage of treatment necessarily includes consultations with a psychologist, during which the specialist will figure out why encopresis has occurred. He will help the child overcome the fear of the disease, reduce nervous tension, and work separately with parents. Sometimes the help of a good specialist is enough to defeat the problem. By listening to the advice of a psychologist and creating a friendly and trusting atmosphere in the family, parents will help the child cope with a delicate problem.

Diet

Proper nutrition will help to avoid the accumulation of feces in the intestines. The emphasis is on easily digestible foods rich in fiber. Cabbage, low-fat soups, salads with sour cream from beets and carrots, dried fruits (prunes, dried apricots), sour-milk products, fruits and berries are obligatory in the child's diet.

It is advisable to limit the consumption of honey, lard, fatty foods, muffins. With the progression of encopresis, dysbacteriosis develops, so doctors often prescribe agents to restore the intestinal microflora. Among them are Linex (Sandoz d.d, Lek), Hilak Forte (Ratiopharm) and others.

Traditional medicine in solving the problem of encopresis

In the treatment of fecal incontinence, sparing folk methods are usually connected. They are aimed at eliminating psychological discomfort, reducing the aggressiveness and anxiety of the child. Among the safe and effective methods that are used after consultation with a gastroenterologist and pediatrician:

• before meals 100 ml. fresh apple or apricot juice;
• evening herbal baths with valerian root, extracts of calendula, chamomile, sage, coniferous;
• warm mint tea before bed to calm and prevent insomnia.

The Importance of Exercise

Physical activity helps fight constipation. In addition to walking and playing outdoors, children with encopresis are shown physiotherapy exercises. Exercises to strengthen the muscles of the abdominal wall, anal sphincter and pelvic floor allow you to fight physiological incontinence. Time is devoted to breathing exercises, sparing gymnastics. However, jumps, jumps, power loads are excluded.