By Dr Mark Muhlmann, Colorectal Surgeon at Prince of Wales Private Hospital
Faecal Incontinence (FI) is the recurring involuntary release of faeces through the anal canal. Faecal incontinence may mean the inability to control solid or liquid stool or gas.
Yes. FI can be subdivided into two broad categories:
Patients also frequently complain of faecal soiling, where stool or mucous is present in the anal area after going to the toilet and wiping.
It is estimated that 1 in 15 Australians suffer FI. The majority of patients never seek medical attention. It is much more common in women and the incidence increases with age.
The causes of FI are often multifactorial and sometimes unknown. One of the most common causes is trauma from previous vaginal deliveries. This often manifests decades after the event. Other causes include trauma from previous anorectal surgery or local anorectal conditions including rectal prolapse, large haemorrhoids and inflammatory bowel disease. Neurological causes include multiple sclerosis, spinal trauma and diabetes.
There are many myths associated with FI. People often believe that FI is an inevitable part of the normal aging process or a consequence of having babies. There is also a belief that nothing can be done to improve continence. These false beliefs mean that a large proportion of people with incontinence never seek help, and those that do often have had issues for many years. There is no need to suffer in silence.
Most FI can be treated by simple non operative measures. Dietary modifications, including either increasing or decreasing fibre can improve continence. Stool bulking agents such as benefiber and Metamucil can help. Medications to firm the stool and slow bowel transit are useful, and some people use enemas on a regular basis to keep the rectum empty, thus avoiding accidents. Pelvic physiotherapy and biofeedback with pelvic floor exercises and muscle re-training are often effective. There are also a number of surgical procedures available to treat the more serious cases of FI.
Dr Mark Muhlmann
BBS (HONS) FRACS
Colorectal and General Surgeon
Prince of Wales Private Hospital
Dr Mark Muhlmann is an Australian educated and trained Colorectal and General Surgeon with over 10 years of experience in consultant practice.
Specialising in colorectal surgery, general surgery, hernia surgery, laparoscopic surgery, colonoscopy and endoscopy. He has appointments in both public and private hospitals.
Dr Muhlmann provides a comprehensive service in all aspects of colorectal surgery. His focus is on minimally invasive surgery in order to ensure minimal levels of discomfort and earliest return back to work and normal function. He performs both laparoscopic and robotic surgery in order to achieve this goal. Commonly treated conditions include colorectal cancer, inflammatory bowel disease (Crohns, ulcerative colitis), diverticular disease, rectal bleeding, haemorrhoids, anal pain, constipation and faecal incontinence.