Incontinence

Question 1

What is the definition of faecal incontinence?

Answer 1

Inability to control or the involuntary discharge of stool or gas

Question 2

What is the epidemiology of faecal incontinence?

Answer 2

Very common in the elderly
affects 8-9% of the population
•most commonly affected - middle aged women and nursing home residents

Question 3

What are the risk factors for faecal incontinence?

Answer 3

• advancing age
• diarrhoea
• urinary incontinence
• multiple childbirths (particularly when vaginal delivery with sphincter tear)
• patients with anal problems ( 3rd or 4th degree tears in childbirth, rectal or pelvic organ prolapse, pelvic radiotherapy or colonic resection, perianal itching, soreness or pain, anal surgery)
• frail elderly patients
• patients with neurological problems or spinal disease (MS, spina bifida, spinal injury)
• patients with severe cognitive impairment or learning difficulties

Question 4

What are the factors that faecal continence depends on?

Answer 4

• mental function
• stool - volume and consistency
• anatomy - sphincter function, rectal distensibility, anorectal sensation and reflexes, anatomical defects

Question 5

What are the causes of faecal incontinence?

Answer 5

•sphincter dysfunction
•impaired sensation
•faecal impaction
•congenital disorders
* other - IBD, rectal prolapse, unwanted anal penetration
•idiopathic

Question 6

What are the sphincter dysfunction causes of faecal incontinence?

Answer 6

• COMMONEST CAUSE: vaginal delivery to pudendal nerve damage

* surgical traume