Incontinence

Fecal incontinence is divided in three various stages. Grade I: spontaneous loss of air. Grade II: Loose stool cannot be kept. Grade III: Solid stool can hardly be controlled.

The continence organ does not only exist of the sphincter but of most importance is the sensor system which means the sensitiveness in this area. Only by sensitiveness we can judge whether it is necessary to relieve and whether wind, loose stool or normal defecation is “ante portas”. To keep the stool will sensitively be disturbed when the rectum had to be minimized after a cancer surgery. Also radiation in this area has a negative impact on the faecal continence.

Physiological decline of the pelvic floor is of most importance. This decline is in particular in women. Pregnancy and childbirth have a negative impact on the pelvic floor; also hard pressing in a chronic constipation leads to a decline of the pelvic floor then followed by stool incontinence.

The treatment depends on the severity and cause of faecal incontinence. Extremely simple and of high effectiveness is the temporal intestinal sedative medication. Here, the motor force of the intestine is reduced for a limited period, the patient may be relatively safe to leave the house and pursue desired activities. The effect is best at inclination of too soft or liquid stools. Water is worse to keep than something solid.

Anal tampons are only exceptionally appropriated to improve suffering. It is more important to relieve the bowels before leaving the house due to outside activities, perhaps by enema or suppositories.

Gymnastic of the pelvic floor is of certain significance. Herewith, one is taught to reinforce the sphincter. Prerequisite is the consequent daily training analog to sportive activities. A Biofeedback training can be added to the gymnastic of the pelvic floor.

Essentially two methods of surgery are used. Firstly, at a sphincter injury e. g. after a perineal laceration during childbirth the sphincter will be sewn and reaped again. A second method is the implant of a sphincter pacemaker. This method is very effective and is called sacral nerve stimulation.