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Causes of Fecal Incontinence

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Updated: September 18, 2006

Fecal incontinence is quite a common condition that can occur at any stage in Alzheimer's disease. Fecal incontinence is stigmatizing, embarrassing and causes misery to both with person with Alzheimer's and their caregiver. In this article we look at the possible causes of fecal incontinence.

Fecal incontinence is a symptom not a disease. Before you can think about treating fecal incontinence you need to determine the cause. Always remember just because someone has Alzheimer's it does not mean that they cannot get sick too!

Causes of fecal incontinence include:
Fecal incontinence caused by diet
Diet should be rich in fiber but not to the point where it causes diarrhea. A balanced diet is important to maintain health and efficient bowel movement. As the body ages it can become more sensitive to certain foods. Good observation skills and monitoring the effect of diet on an individual can help avoid problems.

Fecal incontinence caused by medication side effects
Fecal incontinence may be the result of side effects from medication. Constipation, diarrhea and/or an upset digestive system can be side effects. Gastrointestinal and stomach upsets are common to many drugs.
Do not stop taking the prescribed drug unless your doctor tells you it is OK. Seek his or her advice quickly. Fecal incontinence has many causes, and can be life threatening.
The doctor can decide if tests are needed to diagnose cause of fecal incontinence or may decide to prescribe another type of medication,
It is important to seek help so that the person does not suffer or get more sick.

Fecal incontinence caused by mental state
Emotional states and behavior can affect the way the body responds. You will know when you are anxious that if can affect your toilet habits! It is , of course, the same for anyone with dementia such as Alzheimer's disease.
Fecal incontinence can result from organic dementia and confusion disorders such as those present as a result of medication, mental illness that include depression and mania.

Fecal incontinence due to disease
Fecal incontinence can occur because of disease or conditions. The range shows how important it can be to get fecal incontinence diagnosed properly. Causes include:

  • Muscular Weakness due to disease, surgery, injury.

  • Congenital rectal and anal abnormalities even with surgical intervention can persist into adulthood.
  • Surgical trauma. There are a number of conditions that can be treated surgically that occasionally result in fecal incontinence, for example haemorrhoidectomy (piles), the treatment for anal fistula, some outdated treatments such as manual dilatation.
  • Trauma. Injury to the anus and rectum due to accident or sexual practices.

  • Severe Diarrhea (persistent or intermittent) May be due to infection, irritable bowel, side effects of medication, diseases of the bowel such as ulcerative colitis, Crohn’s disease, Diverticulitis, cancer, radiotherapy.

  • Disorders of the lower bowel due to cancer, anal fistula, hemorrhoids.

  • Disorders of the Nervous System. These can include multiple sclerosis, following a stroke, spinal cord injury, diseases affecting the brain such as cancer, structural abnormalities, as well as dementia.

    Fecal incontinence caused by constipation or Fecal Impaction
    Fecal incontinence can be due to or exacerbated (made worse), by constipation or fecal impaction. Constipation may mean the the patient is passing feces more regularly and unpredictably. Dealing effectively with the constipation may well return the person with fecal incontinent to a more regular pattern of bowel habits once the constipation is cured. Fecal impaction, where the bowel becomes filled with hard feces can cause a lot of problems and is quite common in the bed bound. The result is uncomfortable, painful and can cause the person's mental state to deteriorate dramatically. Overflow diarrhea can also occur making for even more problems. Making a note of bowel habits will avoid impaction. Once impaction occurs a doctor should be consulted on cause and an enema is the usual treatment. It all depends on the cause and the individual medical history.

    Fecal incontinence and urgent medical attention
    Always seek urgent help is you or someone with Alzheimer's has any of the following signs and symptoms;

  • Pain in the rectum

  • Bleeding from the rectum

  • Changes in usual bowel habits

  • Diarrhea that last more than a day or two

  • Dark or black stools

  • Unexplained weight loss

  • Feeling your bowel is never completely empty
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