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Deborah, Nurse (RN)
Category: Health
Satisfied Customers: 3217
Experience:  Registered NP - Multispeciality
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What causes anal seepage and what can be done about it

Resolved Question:

I have an anal seepage problem and was wandering what to do about it
Submitted: 10 years ago.
Category: Health
Expert:  Deborah replied 10 years ago.

Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.

Common causes of fecal incontinence include constipation, diarrhea, and muscle or nerve damage. The condition may be due to a weakened anal sphincter associated with aging. Injury to the nerves and muscles of the rectum and anus are also a cause.

Although bringing the subject of fecal incontinence up with your doctor may be difficult, don't shy away from talking to your doctor about this problem. Many treatments — some of which are simple — are available that can improve, if not correct, incontinence. Continence depends on functioning muscles and nerves in and around the rectum and anal canal. At the lower part of the bowels, the sigmoid colon helps to slow the passage of fecal material before it moves into the rectum. The rectum is more elastic than the rest of the bowel so it can stretch to store fecal material. It is surrounded by nerves that detect expansion of the rectum and signal a sensation of urgency to let us know when it is time to have a bowel movement.

Below the the rectum is the area known as the pelvic floor, which is made up of many different muscles. The puborectalis muscle and the external anal sphincter are voluntarily contracted to prevent leakage of stool when you feel fullness in the rectum. The internal anal sphincter is an involuntary muscle that helps to prevent leakage from the rectum. When it's time to have a bowel movement, all these muscles relax so the stool can pass through the anusMany people with incontinence have pelvic floor abnormalities or dysfunction and may be referred to a surgeon, gastroenterologist, or therapist for treatment such as biofeedback or surgery. Sample treatments include:

* Biofeedback, which may help improve sensation and muscle control. Biofeedback may be used alone or in conjunction with surgery. It is essential to find and work with a therapist knowledgeable in disorders associated with the pelvic floor and rectum. The goal of biofeedback therapy is to:
o Improve ability to detect contents in the rectum
o Improve ability to contract pelvic floor muscles in response to sensation
* Surgery to repair muscle damage is sometimes used to treat incontinence. Different techniques apply depending on the type or extent of damage.
o Sphincteroplasty is a technique to attempt repair of anal sphincter muscles
o Muscle transposition is a technique of transferring a muscle from another part of the body and wrapping it around the anal canal to act like a sphincter.

It may be possible to prevent fecal incontinence, depending on the cause. These actions may help:

* Reduce constipation. Fecal incontinence due to chronic constipation can be improved or eliminated by treating the constipation. Getting more exercise, eating high-fiber foods and drinking plenty of fluids are generally advised to avoid constipation.
* Control diarrhea. If diarrhea is to blame, treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid accidents.
* Avoid straining. Straining during bowel movements eventually may weaken anal sphincter muscles and, at times, lead to fecal incontinence, so avoid straining when possible.

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