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 fecal 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.

Symptoms of fecal incontinence include urge incontinence, which entails a sudden strong urge to defecate, and passive incontinence, where an individual may pass stool without being aware of it. These symptoms can vary based on severity and underlying causes.

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

• childbirth-related injuries resulting in a tear to the anal sphincter or anal sphincter muscles, or injury to the nerves controlling sphincter function

• trauma to anal muscles from anal operations or traumatic injury

• age-related loss of anal muscle strength

• neurological diseases, including changes in the nerves controlling the pelvic floor, affecting bowel movements

• medication side effects

• chronic constipation leading to nerve damage and contributing to rectal incontinence; solid stool can build up in the rectum and lead to liquid stool leakage around it

• causes of fecal incontinence, including diarrhea, constipation, and muscle or nerve damage

• 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.

Factors Contributing to Anal Leakage

Anal leakage, also known as fecal incontinence, can result from a combination of factors. One of the primary contributors is weakened pelvic floor muscles, which play a crucial role in controlling bowel movements. When these muscles are weakened, it becomes challenging to maintain bowel control, leading to leakage.

Nerve damage is another significant factor. The nerves that control the pelvic floor muscles can be damaged due to various reasons, disrupting normal bowel movements and causing anal leakage. Medical conditions such as inflammatory bowel disease, irritable bowel syndrome, and rectal prolapse also increase the risk of experiencing this condition.

Chronic constipation can put undue pressure on the pelvic floor muscles, further contributing to anal leakage. Poor bowel training habits, like ignoring the urge to pass stool or delaying bowel movements, can exacerbate the problem. Additionally, passive incontinence, where a person is unaware of passing stool, can contribute.

Accidental bowel leakage, where involuntary stool loss occurs, can be a symptom of underlying conditions such as fecal impaction, diarrhea, or rectal prolapse. Understanding these factors can help identify the root cause and seek appropriate treatment.

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 centered 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].

Lifestyle Changes to Prevent Anal Leakage

Making certain lifestyle changes can significantly help in preventing anal leakage. One of the most effective changes is modifying your diet. Eating a high-fiber diet and avoiding foods irritating the bowel can help maintain regular bowel movements and prevent leakage.

Regular exercise, particularly Kegel exercises, can strengthen the pelvic floor muscles, improving bowel control. Good bowel training habits, such as responding promptly to the urge to pass stool and not delaying bowel movements, are also crucial.

Managing stress is another important aspect, as stress can exacerbate anal leakage. Techniques such as meditation or deep breathing can be beneficial. Additionally, avoiding heavy lifting or taking regular breaks during such activities can prevent putting excessive pressure on the pelvic floor muscles.

By incorporating these lifestyle changes, you can take proactive steps towards preventing anal leakage and improving your overall bowel health.

When to Seek Medical Attention

If you are experiencing symptoms of anal leakage, it is essential to seek medical attention. Persistent or severe anal leakage should not be ignored, as it may indicate an underlying condition that requires treatment. Other signs warrant medical attention include blood in the stool, pain or discomfort during bowel movements, and difficulty controlling bowel movements.

Additionally, if you experience fever, chills, abdominal pain, or tenderness, it is crucial to consult a healthcare professional. Early intervention can help identify the root cause of the problem and prevent further complications.

Don’t hesitate to seek medical help if you notice these symptoms. Addressing the issue promptly can lead to better management and improved quality of life.

Coping with Anal Leakage

Coping with anal leakage can be challenging, but several strategies can help manage the condition effectively. Practicing good hygiene is essential; keeping the anal area clean and dry can prevent irritation and infection. Using protective products, such as adult diapers or pads, can help manage leakage and avoid accidents.

Seeking support from family, friends, or a support group can provide emotional comfort and reduce isolation. Practicing relaxation techniques, such as deep breathing or meditation, can help manage stress and anxiety related to anal leakage.

Lastly, seeking medical attention is crucial. A healthcare professional can help identify underlying conditions and recommend appropriate treatments. By making lifestyle changes, seeking medical attention, and practicing coping strategies, you can manage anal leakage and improve your quality of life.