Fecal and gas incontinence – an embarassing, unknown, and underappreciated problem. The usefulness of anal endosonography
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 8
Abstract
It is estimated that anal sphincter incontinence affects 2-7% of the adult population (and up to 40% of those aged > 65). The overwhelming majority are women, a finding explained by sexual differences in the anatomy of the sphincter apparatus between men and women, and moreover, by obstetric injury. The extent of the problem is unfortunately not yet known, due to the embarrassing nature of the disease and the consequent under-reporting of fecal and gas incontinence to doctors. In particular, obstetric injuries, the most common cause of incontinence, are even accepted by young women, who see a worsening of fecal and gas continence as natural weakening of the pelvis after labor and the price of bringing forth a healthy child. The most unsettling phenomenon is the lack of prophylaxis, and not taking adequate measures to minimize the risk of anal sphincter incontinence from occurring. The diagnostic work-up of incontinence includes the patient history, a proctological examination, a functional assessment and an imaging study of the sphincters, among the latter endosonography is key. This method allows the differentiation of character of this entity (disruption of the continuity of the sphincter and/or a neurogenic injury) as well as to characterize the extent of damage, which is necessary for choosing the proper treatment (conservative or operative). In the article, the authors discuss the most common causes for injury to the anal sphincters and their characteristic pictures in endosonography.
Authors and Affiliations
Iwona Sudoł-Szopińska, Małgorzata Kołodziejczak
Keywords
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