What Disease Can Cause You to Loose Control of Your Bowels While Asleep and You Not Know

Fecal (Bowel) Incontinence

Fecal incontinence, also chosen anal incontinence, is a term used when bowel movements cannot exist controlled. Stool (feces/waste material) leaks out the rectum at unwanted times. Depending on the cause, treatment tin can include ane or more of these approaches: dietary changes, bowel preparation, medications, or surgery.

Overview

What is fecal incontinence?

Fecal incontinence – as well called anal incontinence – is the term used when bowel movements cannot exist controlled. Stool (carrion/waste/poop) leaks out of the rectum when you don't want it too, which means not during planned bathroom breaks. This leakage occurs with or without your knowledge. Fecal incontinence happens more oft in women than in men and besides happens more than often among older people.

The term fecal incontinence is used if any of these situations occur:

Stool leaks out when passing gas.
Stool leaks out due to physical activeness/daily life exertions.
Feeling like you accept to become and not being able to brand it to the bathroom in time.
Stool is seen in the underwear subsequently a normal bowel motion.
There is complete loss of bowel command.

Why does fecal incontinence happen?

Several factors impact continence of stool or the ability to control bowel move:

Muscles in the rectum and anus (the very concluding two sections of the intestines) must be working properly.
The rectum must exist able to stretch to hold the stool. A "rectal sensation" has to be present to provide alert of the need to motion bowels. When properly working, this means that you get a feeling that it is time to go to the bathroom.
The anal muscles (sphincters) must have the power to squeeze the anus close. If these muscles are not working properly, stool can leave the body unexpectedly.
Yous lack the physical and mental abilities to "recognize the signal" that it is fourth dimension to go to the bath to move bowels, or the concrete quickness to reach the bathroom.
Stools are very watery or explosive or both.

If any of these body functions are non working properly, you lot may have fecal incontinence.

Symptoms and Causes

What causes changes in body functions that lead to fecal incontinence?

Frequent diarrhea or constipation . These conditions cause the muscles in the rectum and anus to weaken. When these muscles weaken, the ability to hold stool within the body also weakens.
Muscle harm. Musculus damage can occur during a difficult vaginal childbirth, when doctors have to use forceps or make a pocket-size cutting (an episiotomy) to brand a larger opening. Muscle damage tin can besides result from anal or rectal surgery.
Older historic period. Muscles in the rectum and anus naturally weaken with age. Other nearby structures in the pelvis expanse also loosen with age. This adds to the general weakness seen in that area of the torso, leading to issues with stool command. Loose stool is more than difficult to control than solid stool. When a big corporeality of loose stool arrives rapidly in the rectum, at that place may non exist enough warning to reach the bathroom in time.
Damage to fretfulness. If the nerves that control the power of the rectum and anus muscles to contract are damaged, incontinence can result. Nerves that control "rectal sensation" can also lead to incontinence if they are damaged. Nerve damage can happen during a difficult vaginal delivery, anal surgery, constipation (resulting in bouts of frequent and astringent straining), or the presence of sure health weather condition (such equally diabetes, multiple sclerosis, stroke or a spinal tumor).
Inability of the rectum to stretch. If the muscles of the rectum are not as elastic as they should be, excess stool that builds upwardly can leak out. Inflammatory bowel disease (such as Crohn'south illness) can also bear upon the rectum'due south ability to stretch. The scars resulting from surgery and radiation therapy can also stiffen the muscles of the rectum.
Other medical conditions. Certain medical conditions, such equally rectal prolapse (the rectum falls downward into the anus) or rectocele (the rectum pushes into the vagina), or chronic constipation where stool leaks around a large stool ball, can lead to fecal incontinence.
Other causes: Laxative abuse, radiations treatments, sure nervous organisation and built (inherited) defects, inflammation (swelling), and inflammatory bowel disease may affect the ability to control stool.

Diagnosis and Tests

What tests are used to diagnose fecal incontinence?

You'll be evaluated by a gastroenterologist and/or a colorectal surgeon who is trained to assistance you. Your doctor will ask y'all questions almost your condition and then perform a physical test and a rectal exam. Don't be embarrassed to talk to your healthcare provider. They sympathise you may feel uncomfortable talking about this problem.

The post-obit tests may be done to diagnose fecal incontinence:

Anal manometry : This test studies the strength of the anal sphincter muscles. A short, thin tube, inserted up into the anus and rectum, is used to measure the sphincter tightness.
Endoluminal ultrasound or anal ultrasound: This exam helps evaluate the shape and construction of the anal sphincter muscles and surrounding tissue. In this test, a pocket-sized probe is inserted upwards into the anus and rectum to take images of the sphincters.
Pudendal nerve final motor latency test: This exam measures the part of the pudendal fretfulness, which are involved in bowel control.
Anal electromyography (EMG): This test determines if nerve damage is the reason why the anal sphincters are not working properly. It as well examines the coordination between the rectum and anal muscles.
Flexible sigmoidoscopy or proctosigmoidoscopy: This examination evaluates the end of the large bowel or colon, looking for any abnormalities — such as inflammation, tumor or scar tissue — that may crusade fecal incontinence. To perform this test, a thin tube with a photographic camera attached at the end is inserted into the rectum upward to the sigmoid colon. This allows the lining of the bowel to be viewed.
Proctography (also chosen defecography ): This exam is done in the radiology department. In this test, an X-ray video is taken that shows how well the rectum is functioning. The video shows how much stool the rectum tin can hold, how well the rectum holds the stool, and how well the rectum releases the stool. To brand the 10-ray video for this test, a small amount of liquid barium is released into colon and rectum (through a tube inserted up into the rectum).
Magnetic resonance imaging (MRI): This examination is done in the radiology section. Information technology is an imaging test sometimes used to evaluate the pelvic organs.

Management and Treatment

How is fecal incontinence treated?

Depending on the cause of fecal incontinence, treatment tin can include one or more of these approaches: dietary changes, bowel training (biofeedback), medications or surgery.

What are medical handling options for treating fecal incontinence?

Dietary tips

The goal of dietary changes is that you avoid foods or drinks that may cause loose stools, including:

Caffeine, alcohol, some fruit juices and prunes.
Beans and cabbage family vegetables.
Spicy foods and cured or smoked meats.
Dairy products.
Artificial sweeteners.

Other foods thicken the stool, which may help fecal control. These foods include:

Bananas.
Apple sauce.
Peanut butter.
Pasta.
Potatoes.
Cheese.

Bowel preparation

There are two types of bowel training. The goal of the first type is to develop a "going-to-the-bathroom" blueprint. By setting up a routine, you tin can gain greater control over your bowel movements. Taking a daily enema at consistent times will help command stool removal and decrease episodes of fecal incontinence. Don't apply an enema without checking with your md kickoff.

The goal of the second blazon of bowel grooming is to learn certain exercises that can strengthen the muscles around the anus. A trained therapist will teach y'all how to locate the right muscles and perform the exercises. This procedure is called biofeedback.

Medications

Medications that are normally prescribed include anti-diarrheal drugs and fiber supplements. These medications decrease movement of the stool through the intestine and firm up the stool. Don't utilize over-the-counter medications without checking with your doctor first.

Skin protection

Since fecal leakage leads to anal skin irritation, wet–barrier creams — such every bit those used for a infant's diaper rash — are used to protect the skin. These products can be used indefinitely. Every bit needed, adult diapers are another consideration. Finally, loose wearable and cotton wool underwear can help provide comfort. Don't use over-the-counter incontinence medications without checking with your doctor first.

What surgical options treat fecal incontinence?

Sphincteroplasty, or overlapping sphincter repair, sews damaged anal sphincter muscles back together (see below left). The anal sphincter muscle is overlapped and stitches are used to secure the muscle on both sides. Overlapping and tightening the sphincter muscle results in a tighter anal opening.

ACE procedure is occasionally appropriate for patients with fecal incontinence. In this process, the surgeon creates a small pathway from the pare on the belly to the bowel. A small-scale tube is inserted through which a daily enema/washout is given to clean out the stool.

Ace procedure | Cleveland Clinic

Artificial bowel sphincter involves implanting an artificial device (prosthesis) effectually the anus. This device is designed to mimic the normal anal muscle.
Sacral nerve stimulation. Sacral nervus stimulation therapy uses a small device (a neurotransmitter) that is implanted under the peel in the upper buttock area. The device sends mild electrical impulses through a pb that is positioned shut to a nerve located in the lower back (the sacral nerve), which influences the bladder, the sphincter, and the pelvic flooring muscles.
Colostomy . In this performance, an opening is made in the abdomen, through which the colon is brought to the surface of the skin. Stool is collected in a special pouch fastened to the belly around the opening. This procedure is commonly considered when all other treatment options have failed.

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Source: https://my.clevelandclinic.org/health/diseases/14574-fecal-bowel-incontinence