Anal incontinence; It is a disease characterized by us being unable to hold our stool (toilet) and intestinal gas in the anal area for various reasons and involuntarily leaking them out. It is popularly called "incontinence", "incontinence", "inability to hold gas" or "inability to hold ablution".
The lives of patients are deeply affected by gas and inability to hold gas. Patients are afraid to leave the house and hesitate to socialize for fear of leaking outside.
Complaints of flatulence and fecal incontinence, which are more common in older age group patients, are more common in women than in men. According to research, it is a disease group that can be seen in 5% to 10% of the human population of all age groups.
Although gas and fecal incontinence have many factors, the factors generally vary according to age groups. To give an example;
- - Psychological reasons are more common in the pediatric age group
- - In the middle age group, the causes are usually after anal area and gynecological surgeries
- - In the older age group, strokes that cause neurological diseases, diabetes and similar causes that affect the nervous system are more common.
The factors that cause gas and fecal incontinence need to be examined item by item. ;
- - Benign anal diseases such as hemorrhoids, anal fissure and anal fistula can be seen after surgeries.
- - Difficult births and large anus. It can be seen due to injury to the muscles of the anal area after the birth of the baby.
- - It can be seen in inflammatory diseases and immunological diseases of the intestine.
- - The last part of the large intestine. It can be seen after radiotherapy and surgery of rectal cancer.
- - It can be seen after continuous use of intestinal softening drugs.
- - In the older age group. It can be seen due to age-related wasting of the anal muscle.
- - It can be seen after neurological diseases that affect the nervous system, such as diabetes and stroke.
- - Anal prolapse, protrusion and intestinal hernia, also known as rectocele, may also be accompanied by the disease.
- - Unlike European countries, In our country, it can be seen due to damage to the nervous system following traffic accidents and bullet injuries.
The diagnosis of the disease can be made by detailed examination of the patient's complaints and history. The anus muscle should be evaluated during the examination. Additional tests may be performed if necessary to evaluate the condition of the anus muscle. Among these examinations, measuring the pressure of the anus muscle, measuring nerve stimulation, evaluating the ability to hold feces during toilet, and examining the anus muscle and surrounding tissue with imaging techniques are the main important approaches.
The treatment of other brand diseases is also possible. As we mentioned, it should be reason-oriented. After grading, in patients with mild incontinence, if there is no accompanying anal muscle injury or neurological disease, the disease can be prevented significantly with strengthening exercises of the anus area and the surrounding muscle layer, called "KEGEL EXERCISES".
In the treatment, the disease can be prevented significantly. One of the important steps is to examine the medications used by the patient. If drugs that cause incontinence are detected among the medications used by the patient, these should be discontinued. Again, if there is a slight incontinence, medications that slow down the intestinal system can be added to the patient's treatment.
In patients with a decrease in anal muscle mass, the anus muscle can be improved and the disease can be prevented, thanks to the home-based inpatient treatment method called BIOFEEDBACK, in order to strengthen the remaining scissor muscle. . With this method, the anal region nervous system is stimulated; In this way, toilet functions that require coordinated action can be taught by reprogramming.
Another treatment method for patients with neurological problems is to stimulate the nervous systems in the sacral region with electrical stimulation applied to the inside of the foot, called PTNS treatment. In this way, bowel movements and anal muscle movements are tried to be coordinated. Thanks to this method, which can be applied at home after patient education, patients can observe a significant regression in their complaints.
If the cause is anal muscle injury, what needs to be done is to surgically repair and restore the damaged part. Although surgical approaches are sometimes successful for this reason, in some patient groups, the muscle group taken from the groin may need to be used to form a new sphincter in the anus. As we mentioned at the beginning, treatment directed at the cause is the correct approach in the treatment of gas and fecal incontinence.
Development or strengthening of the anus muscle in older age patients, in cases where there is nerve loss due to neurological reasons, and in patients with neurological damage such as traffic accidents or bullet injuries. Since methods such as these will not yield results in the treatment, a new dam can be created between the inner and outer muscles with spongy materials called GATEKEEPER AND SFINKKEEPER, which act as a dam in such patients. In this way, patients who cannot control their anal muscle can overcome this dam by straining. and can meet the toilet needs.
All the gas and fecal incontinence treatments we have explained cover only a small part of all treatments.
In patients with advanced disease or in patients who cannot get results despite these treatments.< More advanced treatment methods such as strong>STAM CELL TRANSPLANTATION and TITANIUM ANAL SPHINCTER can be applied.
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