Fecal incontinence

Question 1

causes of fecal incontinence

Answer 1

trauma - operative vaginal delivery, obstetric laceration
neurological- diabetic neuropathy, multiple sclerosis, spinal cord injury, dementia
chronic dx - constipation, hemorrhoids rectal prolapse, infiltrative dx (cancer, systemic sclerosis) and pelvic irradiation

Question 2

overflow fecal incontinence is from

Answer 2

fecal impaction

gien history of dementia, relative immobility and chronic constipation

Question 3

fecal impaction is seen in

Answer 3

elderly and those who have impaired mental function, immobility and inadequate fluid or dietary fiber or decrased sensation of stool in vault

Question 4

what is also often seen with fecal impaction

Answer 4

can apply pressure to bladder and cause urinary incontinence

Question 5

evaluation of fecal incontinence involves:

Answer 5

perineal inspection and digital rectal examination

They should undergo a manual disimpaction and place on a chronic bowel regimen to prevent recurrence.

Question 6

anal sphincter weakness could be caused by

Answer 6

diabetic autonomic neuropathy
surgery (operative vaginal delivery or anal surgery, spinal cord injury and atrophy - from age or infiltration with systemic sclerosis)

Question 7

diabetic autonomic neuropathy resulting in anal sphincter weakness is characterised with

Answer 7

watery painless diarrhea and inability to retain stool in rectum

don’t see constipation

Question 8

decreased rectal complaince means

Answer 8

less ability to store fecal matter and this is seen in people who have ulcerative or radiation proctitis

will see history of radiation

Question 9

rectal prolapse is seen with

Answer 9

chronic constipation

presents are a rectal mass and abdominal pain and blood in mucus and have incomplete rectal emptying.

Question 10

fecal loading is

Answer 10

excess stool in colon

Question 11

fecal incontinence is

Answer 11

involuntary loss of stool

increases with age and 16% of people >70 years

Question 12

urge fecal incontinence is

Answer 12

inability to postpone defecation

Question 13

If someone has fecal incontinence what to order?

Answer 13

Abd XR

• try to see the source of fecal incontinence and explosive diarrhea.

Question 14

fecal loading can present as

Answer 14

explosive diarrhea due to high stool burden in the colon.

Seen in elderly pts and a common cause of fecal incontinence

also seen in hospitalized pts

seen in degenerative neurological disorders

Question 15

Risk factors for developing fecal loading is:

Answer 15

Alzheimer’s dementia
history of constipation
use of constipating medications (memantine and calcium)