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What is Anal Incontinence?

By J.M. Willhite
Updated May 17, 2024
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Anal incontinence is a physiological condition characterized by an individual's inability to control his or her bowels. Treatment for anal incontinence can involve medication and a variety of therapies. Some cases may necessitate surgery to restore proper functionality to the sphincter muscle or to correct a secondary condition, such as a prolapsed bowel or hemorrhoids. Generally associated with advanced age, individuals who have sustained nerve damage due to systemic illness may also develop anal incontinence.

There are several conditions and circumstances that may contribute to the development of anal incontinence. Physiological dysfunction that affects the bowels, including chronic or recurrent diarrhea and constipation, can adversely affect the anal sphincter's nerve and muscle function. Individuals who have sustained anal muscle damage due to injury may experience episodic fecal incontinence. Chronic medical conditions such as rectal cancer or rectal prolapse may also place undue pressure on anal and rectum function, contributing to the development of encopresis.

A diagnosis of anal incontinence is generally made following an extensive consultation and physical examination, including a digital rectal exam. One's medical history generally plays an essential role in the determination of a diagnosis. A battery of diagnostic tests is usually ordered to establish the cause for symptom development. Generally, tests will include an anal manometry and anorectal ultrasonography to assess the functionality of the anal sphincter muscle and evaluate the overall condition of the rectum and anus. Additional testing may include imaging tests to detect any abnormalities indicative of the presence of infection, neoplastic growths, or inflammation.

Individuals with anal incontinence will generally experience a gradual onset of symptoms that may worsen with time. It is not uncommon for encopresis to accompany recurrent constipation and diarrhea. Some individuals may also experience bloating or excessive gas with episodes of fecal incontinence.

Treatment for anal incontinence is generally dependent on the severity of symptoms. Some individuals may experience relief with the implementation of simple dietary changes. Others may require more extensive treatment that involves the administration of anti-diarrheal or laxative medications. Various therapies, including bowel training, may also be usd to strengthen and restore muscle function and regulate bowel movements. Individuals whose anal incontinence is due to an existing condition may require surgery to restore proper bowel function.

Depending on the underlying issue, surgery may be necessary to treat hemorrhoids, repair weakened sphincter muscles, or reposition the rectum. If the sphincter muscle is damaged beyond repair, some individuals may require the implantation of an artificial sphincter muscle. When one’s condition is unresponsive to traditional treatment or if such measures are not feasible, temporary or permanent colostomy placement may be necessary.

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