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Fecal Incontinence

Fecal incontinence is the inability to control bowel movements, causing unexpected bowel leakage. It affects 1.4-18% of the population and is common in nursing home residents and the elderly. Risk factors include age, neurological conditions, pelvic floor dysfunction, and vaginal childbirth. Treatment involves controlling symptoms medically with bulking agents or antidepressants, surgically with procedures like sphincteroplasty, and managing nursing care like hygiene and bowel retraining.

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Binita Shrestha
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140 views25 pages

Fecal Incontinence

Fecal incontinence is the inability to control bowel movements, causing unexpected bowel leakage. It affects 1.4-18% of the population and is common in nursing home residents and the elderly. Risk factors include age, neurological conditions, pelvic floor dysfunction, and vaginal childbirth. Treatment involves controlling symptoms medically with bulking agents or antidepressants, surgically with procedures like sphincteroplasty, and managing nursing care like hygiene and bowel retraining.

Uploaded by

Binita Shrestha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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FECAL

INCONTINENCE
INTRODUCTION
• Fecal incontinence is the inability to control bowel
movements, causing stool (feces) to leak unexpectedly
from rectum.
• Also called or anal incontinence, fecal incontinence
can range from occasional leakage of a small quantity
of stool while passing gas to a complete loss of bowel
control..
• Not a diagnosis but a symptom.
• Affecting between 1.4% -18% of the population
and up to 50% of all nursing home residents.
• Prevalence of fecal incontinence is common in
elderly age group.
RISK FACTORS
• Age, depression, dementia, neurological disease,
immobility
• Constipation, diarrhea
• Female sex, vaginal parity, and a history of
operative vaginal delivery.
• Women with pelvic floor dysfunction
ETIOLOGY
1. Structural abnormality
2. Change fecal volume and consistency
3. Altered mental control
4. Neurological diseases
5. Pelvic floor Dyssynergia (Anismus)
6. Idiopathic
CLINICAL FEATURES
• Diarrhea
• Abdominal pain
• Lower back pain
• Bloating
• Stomach cramp
• Loss of appetite
CLINICAL FEATURES CONTINUE…………

• Insomnia
• Emotional effects
PATHOPHYSIOLOGY
Bowel function is controlled by few factors: anal sphincter pressure,
rectal storage capacity & rectal sensation capacity and rectal
sensation. Anything that interferes with these factors can result in
incontinence.
Fecal incontinence occur when there is direct trauma to the sphincter
muscles such as chronic constipation or obstetric trauma.

The sphincter muscles stretched, weaken & not strong enough to


maintain the continence and stool will leak out.

Patients with impaired continence will also decreased thermal and


electrical sensitivity to stimuli.
DIAGNOSTIC EVALUATION
History taking
Physical examination
Proctosigmoidoscopy
Anorectal manometry
Defecography
Pudendal nerve terminal latency
DIAGNOSTIC EVALUATION CONTINUE….......

Anal endosonography
MRI
Anal ultrasound
MANAGEMENT

Medica Surgical
l
Nursing
MEDICAL MANAGEMENT

1. Controlling symptoms and reducing stress


2. Anticholinergic (hyoscyamine) and
antidepressant (amitriptyline)agent
3. Well balanced diet
4. Bulking agent (methylcellulose)
MEDICAL MANAGEMENT CONTINUE……

5. Control fecal impaction with osmotic laxatives


6. Bowel training
7. Anal sphincter and pelvic floor exercise
SURGICAL TREATMENT

• Sphincteroplasty
• Muscle transposition
• Artificial sphincter
• Diversion colostomy
NURSING MANAGEMENT
NURSING ASSESSMENT
• Assess the patient’s normal bowel elimination
pattern.
• Determine the course of medication that may
contribute to bowel incontinence.
• Assess fluid and fiber intake.
• Assess perineal skin integrity and hygiene.
NURSING DAIGNOSIS

• Fluid and electrolyte imbalance related to


frequent bowel movement.
• Knowledge deficit related to factors that
contribute to constipation.
• Pain related to abdominal distenstion.
NURSING INTERVENTION
• Provide a high fiber diet under the direction of
dietician.
• Ensure fluid consumption of at least
3000ml/day, unless contraindicated.
• Perform removal fecal impaction manually.
• Keep bedside commode.
• Encourage the intake of natural bulking agents
to thicken stools i.e. banana, rice and yogurt.
• Assist patient for mobility or exercise if
tolerated.
• Encourage elimination at the same time each
day.
• Discourage the use of diapers for long term.
• Wash perineal area after each elimination with
water and soap.
• Encourage for high fiber diet.
• Educate about proper hygiene.

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