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Fecal Incontinence

Causes & Risk Factors

Bowel control is governed by the functioning of pelvic and sphincter muscles, the storage capacity of the rectum and one’s neurological status. Any abnormality in the functioning of these aspects can lead to fecal incontinence.5 Individuals who have experienced any muscular or nerve damage to the area, or who suffer from abnormal mental functioning, may not notice or be unable to feel the rectal sensation prior to defecation.

Chronic gastrointestinal distress such as bloating, frequent diarrhea or constipation can have an impact. Conditions that affect sensation and the ability for rectum to hold stool include but are not limited to:9, 8, 11, 1

  • Advanced age

  • Dementia or Alzheimer’s disease

  • Stroke

  • Physical disability

  • Diabetes

  • Childbirth

  • Trauma

  • Anal surgery

  • Nerve damage or malfunction

  • Excessive straining

  • Crohn’s disease

  • Radiation therapy

  • Drug therapy (antibiotics, antiarrhythmics, etc.)

In women, childbirth is the main cause of FI due to damage incurred during delivery.11 In men, prostate cancer and hemorrhoids are common causes, with urinary incontinence often occurring in conjunction with FI.8, 15

Chronic illness and immobility are also frequently associated with fecal incontinence.15

Other health conditions that could cause chronic bowel incontinence include what is known as rectal prolapse, in which the rectum drops down into the anus, and rectocele, in which the rectum protrudes into the vagina.10


References

  1. Arnold-Long, M. (2010). Fecal incontinence: an overview of the causes, treatments, and interventions to address bowel incontinence in the elderly. Long-Term Living: For The Continuing Care Professional, 59(10), 50-53.
  2. Beeckman, D. (2017). A decade of research on Incontinence-Associated Dermatitis (IAD): Evidence, knowledge gaps and next steps. Journal Of Tissue Viability, 26(1), 47-56. doi:10.1016/j.jtv.2016.02.004
  3. Black, P. (2011). Procedures for patients with a colostomy. Practice Nursing, 22(3), 121-124.
  4. Bleier, J. S., & Kann, B. R. (2013). Surgical management of fecal incontinence. Gastroenterology Clinics Of North America, 42(4), 815-836. doi:10.1016/j.gtc.2013.09.006
  5. García, C. B., Binks, R., Luca, E. D., Dierkes, C., Franci, A., Gallart, E., . . . Gibot, S. (2013). Expert Recommendations for Managing Acute Faecal Incontinence with Diarrhoea in the Intensive Care Unit. Journal of the Intensive Care Society, 14(4_suppl), 1-9. doi:10.1177/17511437130144s201
  6. Gump, K., & Schmelzer, M. (2016). Gaining Control Over Fecal Incontinence. MEDSURG Nursing, 25(2), 97-102.
  7. Junkin, J., & Selekof, J. L. (2007). Prevalence of incontinence and associated skin injury in the acute care inpatient. Journal of Wound Ostomy & Continence Nursing, 34(3), 260-269.
  8. Kim, T., Chae, G., Chung, S. S., Sands, D. R., Speranza, J. R., Weiss, E. G., & ... Wexner, S. D. (2007). Faecal incontinence in male patients. Colorectal Disease: The Official Journal Of The Association Of Coloproctology Of Great Britain And Ireland, 10(2), 124-130.
  9. Koloski, N., Jones, M., Kalantar, J., Weltman, M., Zaguirre, J., & Talley, N. (2012). Psychological impact and risk factors associated with new onset fecal incontinence. Journal Of Psychosomatic Research, 73(6), 464-468. doi:10.1016/j.jpsychores.2012.07.013
  10. McNevin, M. (2010). Overview of pelvic floor disorders. Surgical Clinics Of North America, 90(1), 195-205. doi:10.1016/j.suc.2009.10.003
  11. Ness, W. (2012). Faecal incontinence: causes, assessment and management. Nursing Standard, 26(42), 52-60.
  12. Owen Price, R., & Bradley, R. (2013). ASSESSING AND TREATING FAECAL INCONTINENCE. Nursing Older People, 25(7), 16-23. doi:10.7748/nop2013.09.25.7.16.e484
  13. Voegeli, D. (2016). Incontinence-associated dermatitis: new insights into an old problem. British Journal Of Nursing, 25(5), 256-262. doi:10.12968/bjon.2016.25.5.256
  14. Wald, A. (2007). Clinical practice. Fecal incontinence in adults. New England Journal Of Medicine, 356(16), 1648-1696
  15. Whitehead, W. E., Borrud, L., Goode, P. S., Meikle, S., Mueller, E. R., Tuteja, A., & ... Ye, W. (2009). Fecal incontinence in US adults: epidemiology and risk factors. Gastroenterology, 137(2), 1-14. doi:10.1053/j.gastro.2009.04.054
  16. Wilson, M. (2007). Bowel care. The impact of faecal incontinence on the quality of life. British Journal Of Nursing, 16(4), 204-207.
  17. Woodward, S. (2012). Management options for faecal incontinence. Nursing & Residential Care, 14(5), 224-229.