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The potential dangers of long-term constipation: How does it lead to fecal incontinence?
Fecal incontinence (FI), sometimes called constipation incontinence, is the inability to control bowel movements, resulting in the uncontrolled loss of stool (including gas, liquid stool components, and mucus). It is important to note that fecal incontinence is a symptom or finding rather than a stand-alone diagnosis. This condition can have different causes and may occur at the same time as constipation or diarrhea. The ability to control stool is affected by multiple interrelated factors, including the anal sampling mechanism, and incontinence is often the result of defects in multiple mechanisms.
Studies show that fecal incontinence affects approximately 2.2% of community-dwelling adults, while this rate may be as high as 8.39% among non-institutionalized American adults.
The most common causes of fecal incontinence include postpartum damage to the rectum, complications from previous anorectal surgery, changes in bowel habits such as irritable bowel syndrome, Crohn's disease, ulcerative colitis, and overflow incontinence due to constipation. It is worth noting that according to statistics, the rate of fecal incontinence among some older institutionalized elderly people may be close to 50%. The effects of this condition are not only physical, but also include emotional and social stress.
The impact of fecal incontinence
Faecal incontinence has three main consequences: first, local reactions to the surrounding skin and urethra, such as skin eczema, urinary tract infection and pressure ulcers. Second, the economic burden has a significant impact on individuals and society—whether due to medical expenses, the cost of being unable to work, or the cost of purchasing incontinence products. Finally, a reduction in quality of life is often associated with long-term consequences such as lowered self-esteem, shame, depression, and the need to closely plan one’s life to have readily accessible toilets.
According to the report, more than 50% of hospitalized critically ill patients said that fecal incontinence was worse than death.
Faced with these challenges, many people are deterred from seeking medical help due to social stigma, and choose to self-manage symptoms in secret, exacerbating the problem. Fecal incontinence is a medical condition with significant psychological and social burdens in healthy people, but it is often ameliorative with appropriate medical intervention.
Potential causes of fecal incontinenceThe development of fecal incontinence is usually the result of the interaction of multiple factors. Many of these factors may be easily modifiable. Up to 80% of people may have more than one abnormality affecting their bowel function. One of the main factors is postpartum trauma, especially the complications that may arise during surgery involving the anal sphincter. In addition, neurological diseases, intestinal dysfunction, and emotional or behavioral disorders may also lead to incontinence.
Many women may suffer damage to the pelvic muscles and nerves after a natural childbirth, which can be a major cause of fecal incontinence.
The risk of injury increases significantly during labor, particularly when an ingestion device is used, labor is prolonged, or when the baby is heavy. These hidden injuries may not show up immediately after childbirth, however, they may suddenly become apparent after exposure to changes such as menopause. For those who have undergone surgery, such as hemorrhoid removal or rectal surgery, this may also trigger the risk of fecal incontinence. Postoperative injury may lead to weakening of the anal sphincter muscles, which may affect their ability to control the anus.
Psychological impact of fecal incontinence
The impact of fecal incontinence on an individual's mental, social, and professional life is wide-ranging. The emotional effects it may cause include anxiety, stress, shame and isolation, and even a temporary reduction in enthusiasm for social activities. In fact, many patients struggle to control themselves emotionally, interfering with their daily lives and relationships.
These symptoms may worsen over time, threatening physical and social activities and overall quality of life. For many patients, unbearable embarrassment and constant psychological burden make them feel overwhelmed when dealing with this condition. As the burden on their hearts grows, is it possible to give them the courage to seek help?
