Fecal incontinence is usually concealed

Nobody likes to talk about faecal incontinence

09/30/2014

According to estimates, around five million people in Germany can not consciously control the excretion of their stool. The cause of this can sometimes be a stroke, Alzheimer's disease or a pelvic floor weakness. No one likes to talk about his fecal incontinence and keeps it secret. There are therapies with which the symptoms can be alleviated.

Many sufferers keep their suffering secret
It is estimated that around five million people in Germany can not consciously control the excretion of their stool. This may be due to a pulse processing disorder, such as stroke or Alzheimer's disease. A pelvic floor weakness can be the trigger for it. Most are ashamed of those affected and try to keep their suffering secret. There would be effective therapies that allow doctors to treat fecal incontinence and relieve symptoms, as the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) announced.

Open conversation with the family doctor
„Fecal incontinence should not be a taboo topic“, thinks DGVS-Advisory Council Professor med. Peter Layer, Hamburg. „For most patients there are long-term effective aids.“ An open discussion with the GP is the first step. If necessary, he will issue a referral to a gastroenterologist. With the help of an endoscopy or ultrasound, the gastrointestinal specialist can then determine whether there is a chronic intestinal disease and examine the sphincter. Based on the results, he decides which therapy is suitable for the patient. „A common cause is, for example, a weakening of the pelvic floor muscles, ie the muscle group that holds the exits of the bladder and intestine tight“, so the expert.

Function of the sphincter impaired
The function of the sphincter may also be affected as a result of birth defects or surgery. Prof. Layer added: „In people with diabetes mellitus or in stroke patients, the perception of the nerves at the intestinal outlet may also be so attenuated that the patient no longer notices the urgency of the stool.“ Every fourth affected person is already helping to feed themselves differently. „A fiber-rich diet increases the volume and consistency of the stool so that it can no longer escape easily“, explained Prof. Layer. Even medications that make the stool firm or reduce intestinal activity can help.

Strengthen the pelvic floor muscles
Pelvic floor and sphincter can be trained in the long term with gymnastic exercises. Strengthening the pelvic floor muscles is also a frequently recommended method for patients suffering from urinary incontinence or having problems such as frequent urination / urination. The training effect can also be enhanced by so-called biofeedback. The doctor introduces a probe through the anus, which measures the tension in the pelvic floor muscles. The result can be read by the patient on a scale. „Patients get a better sense of their muscles“, says Prof. Layer. „Nearly 80 percent of those treated learn to control the sphincter again.“

Surgical procedures
Although experts say around two-thirds of all cases of fecal incontinence can be cured without surgery, surgical procedures are also available if conservative treatment does not help. „For example, if there is a perineal tear, a surgeon can surgically correct the defective sphincter“, explained Prof. Layer. The sacral nerve stimulation offers a further possibility. The surgeon builds electrodes at the intestinal exit, which stimulate the sphincter muscle. The patient can control these electrodes himself with a small remote control when a toilet is pending.

Especially older people are the victims
Although fecal incontinence can affect people at any age, older people are particularly likely to suffer. A US survey found that more than 15 percent of over-70s suffer from fecal incontinence. Either those affected do not notice the urge to stool or they can not hold the chair long enough to reach the toilet. Women are affected much more often than men. In addition to the main problem is that those affected by shame do not talk about it and try to cope with the situation on their own, with the result that more and more withdraw and become lonely. In addition, the problem is often called „diarrhea“ designated and therefore mistreated. Therefore, the DGVS also advises relatives to address the problem and to inform those affected about the possibility of medical assistance. (Ad)