What Causes Anal Leakage: What You Need to Know About Rectal Incontinence
By Heath Beckham, MD, FACS, FASCRS
When most people hear the words “rectal incontinence,” they do not think warm, happy thoughts. Embarrassment, shame, denial, and other negative emotions often come up. But as you might expect, at a place nicknamed, The Butt Hutt, rectal incontinence is something we have a lot of experience helping patients with. There are solutions, and it's nothing to feel wrong about.
How Common Is Fecal Incontinence?
Rectal incontinence, also called bowel incontinence or faecal incontinence, is the inability to control one’s bowel movements, causing uncontrollable leakage from the rectum. The inability to control bowel movements can lead to accidental bowel leakage. The condition has a range of severity, from occasional stool leakage while passing gas to a complete loss of bowel control. The term “accidental bowel leakage” is also used and sometimes preferred.
The condition is not uncommon. Between 1% to 15% of patients have some degree of symptoms. It is more common in women than men and older patients than younger ones. In a study of 6,000 women over 45, 20% reported an episode at least once yearly, and 9.5% reported an episode at least once monthly.
Causes of Rectal Incontinence: Anal Sphincter Muscles
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childbirth-related injuries resulting in a tear to the anal sphincter or anal sphincter muscles, or injury to the nerves controlling sphincter function
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trauma to anal muscles from anal operations or traumatic injury
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age-related loss of anal muscle strength
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neurological diseases, including changes in the nerves controlling the pelvic floor, affecting bowel movements
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medication side effects
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chronic constipation leading to nerve damage and contributing to rectal incontinence
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causes of faecal incontinence, including diarrhoea, constipation, and muscle or nerve damage
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rectal prolapse, worsening constipation, and contributing to rectal incontinence
It probably goes without saying that with any of these issues and with any degree of severity, the biggest challenge often involves the embarrassment people feel. It can also be a socially isolating condition that can alter the patient’s lifestyle.
Solutions for Rectal Incontinence and Bowel Control
But there is good news. While treatment for rectal incontinence is very individualized, we do have options through nonsurgical and surgical methods. Nonsurgical options involve dietary changes, constipating medications, muscle-strengthening exercises, biofeedback, and bowel training. Constipating medications can help make liquid stool more solid and more accessible to control. Surgical options often involve surgical muscle repair, stimulation of the nerves, and surgical colostomy.
Depending on the exact situation, the causes of rectal incontinence, and the severity of the symptoms, the patient’s quality of life is usually improved to varying degrees with treatment. Some patients may not be aware of the need to pass stool, leading to passive incontinence. Rectal incontinence does not have to be a lifelong problem or drastically reduce your quality of life. Don’t feel embarrassed to talk to your doctor about treatment options. We have seen and heard it all before and would love to help you live a life not defined by rectal incontinence.
Alabama Colon & Rectal Institute is centred around treating diseases of the colon, rectum, anus, and pelvic floor muscles.
Alabama Colon & Rectal Institute (also known as the “Butt Hutt” around town!) has been in practice since 1990 as a free-standing, private practice located in downtown Birmingham, Alabama. We are known for our efficiency and patient care in a more relaxed, office-based setting. Our doctors are known regionally for their expertise and are active in teaching surgical residents and other physicians. We are also a major sponsor of The Rumpshaker 5K, a race promoting colorectal cancer awareness. Check out our website for more information; call us to make an appointment at (205) 458-5000, or email us at [email protected].