Hemorrhoids, constipation, incontinence and other “shameful” problems that are not used to talk
Not with every problem, the patient can come to the doctor and tell at the reception what worries him. For example, if a person has a toothache, he calmly goes to the dentist and talks about a toothache. But if the problem is delicate, and it is rather difficult to voice it, not only to the doctor, but also to close people, then a special approach is needed. First of all, we are talking about incontinence – incontinence of feces and gases, which has a largely negative impact on the quality of life and self-esteem of the patient as a whole, becoming a global cause of loss of social circle and disability.Incontinence is defined as an uncontrolled release of feces or gases for at least 1 month in a person over 4 years old, provided that these physiological functions were previously controlled.
Causes of incontinence
It is rare to single out one main reason for the development of this condition. In almost all patients, the development of fecal incontinence has several causes, and the disease is considered as complex.
Pregnancy, chronic diarrhea, diabetes mellitus, prior coloproctological interventions, urinary incontinence, smoking, obesity, a sedentary lifestyle, belonging to a Caucasoid race are all risk factors for the development of incontinence.
The function of retention of feces and gases is due not only to the anatomical integrity of the sphincter, but also to the consistency of feces, as well as the state of the nervous system. According to the form of development of fecal incontinence, organic (when the integrity of the sphincter is broken), inorganic (functional) and mixed are separated.
We currently do not have detailed statistics on who is more likely to suffer from this disease and why. The prevalence, according to various studies, varies from 1.4% to 18%. According to a study of maternal health, in which about 6,000 women from 45 years of age took part, 20% of fecal incontinence episodes occurred at least once a year, while 9.5% experienced this problem once a month.
Incontinence treatment methods
Dieting and medical monitoring are recommended as primary therapy for patients with fecal incontinence. Particular attention should be paid to the effects of caffeine, sugar substitutes, lactose and other food additives that can cause diarrhea. In 22-54% of patients, dieting has a positive effect. Evacuation of intestinal contents using enemas or suppositories leads to a reduction in the volume of rectal contents and may in some patients reduce the risk of incontinence episodes.
Currently, sacral neuromodulation is considered the first line of surgical treatment for fecal incontinence. All modern studies confirm that, on average, 79% (69-83%) of patients after such treatment show an improvement of more than 50% in episodes of fecal incontinence a week in the first year after surgery, and 84% report an improvement in the long-term period (more 36 months)
Under the skin, a generator is installed that delivers weak impulses to the nerve fibers involved in the bladder and intestines. The device normalizes urination, solves the problem of fecal incontinence, eliminates pelvic pain in patients with neurogenic disorders. The effectiveness of the method has been proven in studies involving more than 25 thousand patients.