Anal incontinence, an undervalued pathology
Written by:Undoubtedly the anal incontinence is one of the more digestive pathologies that alter the quality of life of patients, not by their gravity, but for what it can be debilitating for the sufferer. Interestingly doctors have given little importance and many still ignore the diagnostic and therapeutic possibilities of which are available today.
It can be defined as the repeated loss of voluntary control of the anal continence: is not incidental, it may be for gases, liquids or solids and occurs in individuals over 4 years of age
.It occurs between 3 and 7% of the population but most do not go to the doctor for verg Wü, embarrassment or ignorance of current techniques. It is more common in :. Females, aged 65 years and difficulties in mobilizing
The causes of incontinence can be many:
-Alterations Or loss of strength in the muscles or anal sphincters: after anorectal interventions (fissures, fistulas, hemorrhoids), multiple or difficult childbirth, trauma and stretching the pelvic nerves ( constipation )
Decreased rectal sensitivity: by dementia, elderly, spinal cord injury, stroke and multiple sclerosis
Decreased rectal capacity: infectious proctitis, actinic roctitis ( after radiotherapy), inflammatory bowel disease and some rectal tumors
.The diagnostic tests to perform are:
1 . detailed clinical history of the patient
2 . physical examination including a digital rectal examination
3 . Psychological Support
4 endoanal Ultrasound to assess for lesion in sphincters
.5 . anorectal manometry to assess anorectal function
Treatment
Depending on the type and severity of incontinence there are several possibilities that can be applied jointly or in isolation.
• Diet: input fiber and bulking agents
.-Farmacos: Loperamide
-Biofeedback Anorectal
-Surgery Restorative or prosthetic.
Of all of them perhaps less known is biofeedback, a technique nothing annoys patient that is done through a computer and through which they learn to perform a series of exercises to improve the strength of the anal sphincters and subsequently practice them at home.