Cause of fecal incontinence, fecal incontinence is caused by what the cause

fecal incontinence is caused by what the?

(a) causes

1. anus, congenital malformations

(1) nervous system defects: Congenital lumbosacral myelomeningocele or spina bifida may be associated with incontinence, the patient puborectalis sphincter and loss of normal nerve, no contraction, in the flaccid state, and because sensory and motor systems are affected, rectal mucosa filling the lack of expansion in the stool a sense of meaning and can not cause it to launch bowel movements, rectal fecal discharge at any time, this disease is often associated with urinary incontinence in children.

(2) anorectal malformation: anorectal and pelvic structure itself are changed, and the blind end of the rectum higher, the more obvious changes, the more complex, high deformity rectum blind side in the basin above the diaphragm, short puborectalis reduced, significantly above the forward displacement; sphincter absent or only in the prototype state; more than a loose sphincter state, which is fraught with adipose tissue, abnormal muscle fibers Traveling disorder, some authors followed up 225 cases of anorectal malformations after sick children, 80 patients (35.5%) will have different levels of pollution or incontinence, abnormal position of the higher, the higher incidence of incontinence, its causes major malformations associated with the organizational structure of sensory and motor nerve defects, but also with surgery, trauma, surgery errors clearly related to the past, treatment of high abnormal abdominal perineal anus angioplasty, the rectum is not through the puborectalis ring, and in its later decline, anorectal malformations, particularly malformations associated with high sacral malformations, neurological defects were not caused by rare, according to Jiehioiiikhh analysis, postoperative incontinence were about 10% is for this reason, in the low abnormal postoperative anal incontinence, mainly due to surgical injury, infection and other factors, such as cloacal malformations, mainly for the babys rectum and anal canal , urethra, vagina of one hole, and often after the baby high imperforate anus fecal incontinence, congenital dementia, brain spina bifida, multiple sclerosis and other fecal incontinence can occur.

2. injury due to trauma injury of the anorectal ring, the loss of sphincter sphincter function to fecal incontinence, such as stab wounds, cuts, burns, frostbite, and lacerations (mainly for women during childbirth perineal tear split), and anorectal surgery, injury, such as anal fistula, hemorrhoids, rectal prolapse, rectal and other surgery-induced injury of the anal sphincter fecal incontinence.

3. more common nervous system lesions in the brain trauma, brain tumors, stroke, spinal cord tumors, spinal tuberculosis, cauda equina injury can lead to fecal incontinence.

4. anorectal disease is the most common anorectal cancer; such as cancer, anal cancer, Crohns disease involving the violation of the anal canal and rectum to the anal sphincter, or chronic diarrhea caused by ulcerative colitis inflammation of the anal canal, or anal rectal prolapse caused by relaxation, as well as severe perianal scar to the anal sphincter, anal atresia insufficiency that can cause fecal incontinence.

(B) the pathogenesis

1. pathophysiology of defecation is a common human multiple systems involved in the process of coordination and unity, feces reach the rectum, first of all have a certain rectal compliance, stool accepted, normal for the 250ml, rectal contents after a certain amount of to stimulate the rectal receptors, through afferent nerve fibers passing center, and then through the efferent nerve fibers to reach the external sphincter and levator ani muscle, central determination conditions permit, then the external sphincter relaxation, increased intra-abdominal pressure to complete defecation, for some reason does not allow defecation, then the external sphincter contraction by arbitrary oppression of the internal sphincter, the sphincter inhibitory reflex rectal contraction reverse to rectal distension, the volume increases, or the reverse peristalsis through the rectum push the feces back to the sigmoid colon, it means disappeared, Such voluntary contraction stimulated by the external sphincter to reverse inhibition of rectal sphincter contraction, said arbitrary inhibited defecation is a very complex process, a part of any damage can be caused by fecal incontinence, such as rectal compliance is too low can cause the stool increase in the number of serious and even fecal incontinence, compliance is too high, can cause rectal volume increases, patients with constipation, such as arbitrary inhibition reduces fecal incontinence can also occur, and abnormal rectal receptors, or sphincter damage may occur stool incontinence, in short, fecal incontinence are more reasons, but also to be further explored.

2. classification

(1) according to the degree classification: According to the different degrees of fecal incontinence: can be divided into complete and incomplete incontinence two kinds, ① incomplete incontinence: thin stool and gas can not control, but dry stools can be controlled , ② complete incontinence: dry stool, loose stools and gas can not be controlled.

(2) by nature: according to the nature of incontinence, incontinence is divided into sensory and motor incontinence, ① sensory incontinence: the normal form of the anal sphincter, but the rectal sensory loss, such as spinal cord or the brain center neurological dysfunction caused the incontinence; or because of low rectal compliance, stool frequency, fecal incontinence caused by an increase in serious, ② exercise-induced incontinence: external anal sphincter mainly for the damage destruction of the anorectal ring, resulting in patients not at liberty to control bowel movements caused the incontinence.