Intestinal & Anorectal Physiology Treatments
Incontinence is the impaired ability to control gas or stool. Its severity ranges from mild difficulty with gas control to severe loss of control over liquid and formed stools. Incontinence to stool is a common problem, but often it is not discussed due to embarrassment. Both bladder and bowel incontinence are problems that tend to increase with age.
Common Questions about Anal Incontinence
- What Causes Incontinence? There are many causes of incontinence. Injury during childbirth is one of the most common causes. These injuries may cause a separation in the anal muscles and decrease in muscle strength. The nerves supplying the anal muscles may also be injured. Anal operations or injury to the tissue surrounding the anal region similarly can damage the anal muscles and hinder bowel control. Infections around the anal area may destroy muscle tissue leading to problems of incontinence. In addition, as people age, they experience loss of strength in the anal muscles.
- What are Treatment Options for Anal Incontinence? Treatment of incontinence may include dietary changes, constipating medications, muscle strengthening exercises, biofeedback, surgical muscle repair, gracilis muscle transposition, and artificial anal sphincter.
Constipation is a symptom that has different meanings to different individuals. Most commonly, it refers to infrequent bowel movements but it may also refer to a decrease in the volume or weight of stool, the need to strain to have a movement, a sense of incomplete evacuation, or the need for enemas, suppositories, or laxatives in order to maintain regularity.
About 80 percent of people suffer from constipation and constipation pain at some time during their lives and brief periods of constipation are normal. Constipation may be diagnosed if bowel movements occur fewer than three times weekly on an ongoing basis.
Common Questions About Constipation
- What Causes Constipation? There may be several, possibly simultaneous, causes for constipation including inadequate fiber and fluid intake, a sedentary lifestyle, and environmental changes. Constipation may be aggravated by travel, pregnancy, or change in diet. In some people, it may result from repeatedly ignoring the urge to have a bowel movement. In women, rectocoele can create difficulty in expelling stool, a symptom of constipation.
- When Should I See a Doctor About Constipation? Any persistent change in bowel habit – increase or decrease in frequency or size of stool or an increased difficulty in evacuating – warrants medical advice. Whenever constipation symptoms persist for more than three weeks, you should consult your physician. If blood appears in the stool, consult your colon and rectal surgeon right away.
- How are Constipation and Constipation Pain Treated? The vast majority of patients with constipation are successfully treated by adding high-fiber foods like bran, shredded wheat, whole grain breads, and certain fruits and vegetables to the diet along with increased fluids. Your physician may also recommend lifestyle changes. Fiber supplements containing undigestible vegetable fiber, such as bran, are often recommended and may provide many benefits in addition to relief for constipation. Other types of laxatives, enemas, or suppositories should be used only when recommended and monitored by your colon and rectal surgeon. Designating a specific time each day to have a bowel movement also may be very helpful to some patients. In some cases, biofeedback may help to retrain poorly functioning anal sphincter muscles. Only in rare circumstances are surgical procedures necessary to treat constipation. Your colon and rectal surgeon can discuss these options with you in greater detail to determine the best treatment for you.
Almost everyone has occasional diarrhea — loose, watery stools often accompanied by more-frequent bowel movements, abdominal pain, abdominal cramps, bloating, blood in stool, nausea, and fever. In most cases, diarrhea lasts no more than two days. When the condition continues for weeks, it may indicate a more serious problem – persistent infection, inflammatory bowel disease, or a less serious condition known as irritable bowel syndrome (IBS).
What Causes Diarrhea?
There are many possible causes of diarrhea. These include:
- Bacteria and parasites
- Lactose intolerance
- Artificial sweeteners
- Fructose (fruit sugar)
- Abdominal surgery or gallbladder removal surgery
- Digestive disorders (Chrohn’s disease, colitis ulcerative, celiac disease, irritable bowel syndrome, and microscopic colitis)
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a common disorder that may affect up to 30 percent of all Americans at some time during their lives. The disorder has many names, including nervous colon, spastic colon, spastic bowel, mucous colitis, and spastic colitis. However, it should not be confused with diseases like colitis ulcerative or Crohn’s disease.
IBS is a syndrome, a pattern of symptoms such as pain and bloating that tend to occur together. It is not a “disease” in the normal sense of the word (i.e., it cannot be caught or transmitted from person to person as a cold can nor can it be cured by an operation or medication). It is not life-threatening. This is a “false” colitis in comparison to colitis ulcerative or Crohn’s disease, which are “true” colitis diseases.
Common Questions of IBS
- What are the Symptoms of IBS? People with IBS may experience constipation, diarrhea, or a combination – constipation at some times and diarrhea at other times. In addition, IBS may produce cramps, urgency, or a gassy, bloated feeling in the abdomen. Mucus, sometimes seen in bowel movements, is also a symptom of IBS.
- What Causes IBS? The underlying cause of this disorder is an abnormality in the way the intestinal muscles contract. These muscles, which form the outer layer of the intestine, work automatically to move food products along the intestine to the rectum and out the anus. IBS is a disorder of the function of the intestinal muscle.
- What is the Treatment for IBS? Simply understanding that IBS is not a serious or life-threatening condition may relieve anxiety and stress which often contribute to the problem. Mental health counseling and stress reduction (relaxation training) can help relieve the symptoms of IBS in some individuals. In others, increasing the amount of nondigestible, bulk-forming foods (“roughage”) in the diet may be all that is needed to relieve symptoms. Adding roughage, such as psyllium seed, to your diet may eliminate or lessen the severity of cramps, result in softer stools that pass along the intestine more easily and absorb excess water in the intestine to prevent diarrhea. When the major complaint is constipation and constipation pain, additional water should be provided in the diet along with bulk agents to soften the stool. In some cases, dietary roughage alone may not provide adequate relief from cramping and bloating. Your physician may prescribe medications that act directly on the intestinal muscles to help the contractions return to normal. Some people obtain greater relief from one medication than another. Therefore, your physician may recommend changing medications to improve symptomatic relief.
Rectal prolapse is a condition in which the rectum (the lower end of the colon, located just above the anus) turns itself inside out. In the earliest phases of this condition the rectum does not stick out of the body but as the condition worsens, it may protrude. Weakness of the anal sphincter muscle is often associated with rectal prolapse at this stage and may result in leakage of stool or mucus. The condition occurs in both sexes, although it is more common in women than men.
Common Questions About Rectal Prolapse
- Why Does It Occur? Several factors may contribute to the development of rectal prolapse. It may come from a lifelong habit of straining to have bowel movements or as a delayed result of stresses involved in childbirth. In rare cases, there may be a genetic predisposition in some families. It seems to be a part of the aging process in many patients who experience weakening of the ligaments that support the rectum inside the pelvis as well as loss of tightness of the anal sphincter muscle. In some cases, neurological problems, such as spinal cord transection or spinal cord disease, can lead to prolapse. In most cases, however, no single cause can be identified.
- How is Rectal Prolapse Treated? Although constipation and straining may be causes of rectal prolapse, simply correcting these problems may not improve the prolapse once it has developed. There are many different ways to surgically correct rectal prolapse. Abdominal or rectal surgery may be suggested. Your doctor can help you decide which method will most likely achieve the best result by taking into account many factors, such as age, physical condition, extent of prolapse, and the results of various tests. Most commonly, surgery is done through the abdomen and is called the Ripstein procedure.