Constipation and Stools Incontinence

Constipation

Constipation is a digestive problem that consists on the difficulty to excrete. Both the difficulty to passing stools and the low frequency of doing it can be considered constipation.

Popular belief that constipation means the lack of daily excretion is mistaken as the normal frequency varies from three times a day to three times a week.

Constipation as such is not a disease but a problem that everyone experiments at some stage of their lives. However if it turns chronic it is necessary to visit a specialist in digestive system to study the causes and possible solutions.

At present, nearly 30% of the population suffers constipation and it is twice as frequent in women as in men. This difference increases with age especially after 65 years of age. It is also more frequent in sedentary people, during pregnancy and in patients with irritable bowel syndrome and functional dyspepsia (difficulty to digest properly).

Stool Incontinence

Stool incontinence is the inability to voluntarily control the anal sphincter so control of intestinal evacuation is lost either of solid or liquid stools or gases.

It is a disabling disease that affects the quality of life of patients. In many cases it can lead to isolation and depression. Patients are reluctant to see the specialist and benefit from an efficient medical treatment so it is under diagnosed. It is estimated that the prevalence in general population is of 3%, increasing up to 10% in people over 60 years of age and up to 50% of inpatients or patients in residences.

Constipation and Stool incontinence Unit

Constipation and anal incontinence are two digestive pathologies affecting a large number of people and that considerably reduce their quality of life. However, in many cases patients are unaware of the therapeutic options existing at present or have not received professional treatment adapted to their needs.

Constipation and Stool Incontinence Unit of CMED relies on a medical team with the skills and technical means necessary to provide a diagnosis and offer their patients the most appropriate treatment.

Constipation symptoms

• Feel the need to excrete even after doing so.
• Excrete less than three times a week.
• Hard and dry stools difficult to excrete.
• Feel a blockage of the intestine and rectum.
• Having to push hard to excrete.
• Changes in normal intestinal movements.

Causes of constipation

Constipation is observed when stools pass slowly through the intestine which makes them dry and hard with the subsequent difficulty to excrete them. Among the causes of this slowing we find:

• Not eating enough amount of fiber: Specialists recommend a daily intake per adult of around 20-25 grams of fiber.
• Not taking enough liquid: It is recommended to drink between 1.5 and 2 liters of water per day.
• Have a sedentary life: Physical activity improves intestinal transit.
• Not going to the toilet when you need it: Accumulating stools making more difficult their excretion.
• Consumption of certain drugs: To know if this is the cause we advise to read the prospectus of the drug prescribed.
• Change of life and daily routines: During pregnancy constipation is normal as happens to some people when they travel.
• Intestinal problems: such as the irritable bowel syndrome or the presence of polyps.
• Some diseases: certain pathologies such as diabetes, hypothyroidism and lupus may also cause constipation.

Symptoms of stool incontinence

Symptoms may be of different severity so it is very important to see a specialist in case of onset of any of them.

• Stain or dirty underwear.
• Not getting to the toilet on time.
• Involuntary loss of gases, liquid stools and solid stools.

Types of stool incontinence

• Urgency incontinence, takes place when you feel that the rectal area is full and you have to run to get to the toilet on time.
• Gas incontinence, the patient has the feeling that it is full but the sensitive mechanism of that area does not work properly and cannot tell whether it is gas or stools.
• Passive incontinence, people suffering from it do not feel the need to go to the toilet because the brain has not notified the urgency and therefore stools exit without them being aware of it.
• Overflow incontinence, it is normally the result of the colon blockage caused by constipation. Such blockage caused by impacted stools, blocks stools even more. Only watery stools can pass through this blockage causing losses due to the difficulty to control them.
• Double incontinence, when there is no control of rectal sphincters and no control of urine.

Causes of fecal incontinence

There are many possible causes of fecal incontinence. Most of them are related to an injury or poor functioning of nerves and muscles controlling the movements of our intestines. Some of the causes are:

• Injury of anal sphincters: one of the most common causes of this type of injuries has to do with gynecologic surgeries, vaginal deliveries or accidents.
• Digestive diseases: Patients with inflammatory bowel disease or irritable colon may suffer losses due to the urgency to excrete.
• Other diseases: Diabetes or Parkinson can also cause the loss of voluntary control of anal sphincter.
• Alterations of excretion routines: For example when laxatives are used on a continuous basis or in case of chronic diarrhea.
• Aging.

Diagnose of constipation and stool incontinence

Both constipation and stool incontinence are common problems affecting the quality of life of patients suffering from them However, many people feel ashamed for these problems and decide not to visit their physician specialist in the digestive system when he is the one able to help them solve it.

The professional and personalized diagnosis is essential for the treatment of these diseases. Digestive system specialists of CMED will elaborate a clinical history stating the symptoms and its medical background both of the patient and its family.

In addition to the physical examination among the different tests that may be prescribed there are:

• Abdominal Ultrasound.
• Abdominal radiology.
• CT-Scan.
• Endoanal Ultrasound.
• Colonoscopy.
• Rectal manometry.

Treatment of constipation and stool incontinence

The specialist in the digestive system of CMED will prescribe a personalized treatment based on its clinical history, physical examination and the result of diagnostic tests.

Treatment may consist on diet and healthy habits, exercise for the strengthening of pelvic floor, instructions on the use of laxatives, medication and if necessary, surgery.