Can fecal incontinence be cured?

Fecal incontinence can be treated, mainly because this condition is caused by abnormalities in the nervous system that make it impossible to control the anus. Therefore, fecal incontinence needs to be treated in a timely manner, and the anus and rectum need to be cleaned. It can be treated with medication and physical exercise. Now let us understand the treatment effect of fecal incontinence.

1 General treatment: Diet adjustment (limit milk and dairy products, appropriate intake of water and fiber-containing foods), increase activity, and the elderly should appropriately strengthen physical exercise. For overflow fecal incontinence, efforts should be made to cultivate patients' regular bowel movement habits, using the principle of gastrocolic reflex to encourage patients to defecate 30 minutes after meals. For overflow fecal incontinence in children, the first step in treating it is to educate the family and parents, instructing the children not to hold back their bowels, to go to the bathroom regularly to completely empty their rectums, and to use cleansing enema if necessary, once a week. For anal chemical dermatitis, patients should be helped to master hygienic techniques to avoid physical damage to the anus and the surrounding skin, and to use mild lotions to clean the anus and lotions to protect it.

2 Drug treatment Regardless of the function of the anorectum, for FFIC complicated by diarrhea, efforts should be made to control diarrhea. Large-volume fiber substances such as psyllium or non-specific antidiarrheal agents such as diphenoxylate can be used. For FFIC caused by intestinal motility disorders, codeine, phenoxylate and loperamide can be used for treatment. Loperamide can improve the number of daily bowel movements and urgency, increase IASP, and increase bowel control. The commonly used dose is 2-4 mg every night, and the maximum dose is 16 mg/d. Note that large doses of this drug may cause adverse reactions such as severe constipation. Incontinence of formed stools may be exacerbated by the use of antimotility drugs. For fecal incontinence caused by bile salts, cholestyramine can change stool consistency and has a significant effect on many patients, but there is no rigorous clinical trial to prove this effect. Osmotic laxatives are suitable for overflow incontinence. For example, the elderly can use 10ml of lactulose twice a day, plus a cleansing enema once a week, with an effective rate of over 90%. For those with obvious constipation, appropriate use of laxatives or drugs to soften stools. After intestinal cleansing, about 60% of children can achieve complete continence within 1 year, and another 23% of patients have a significant reduction in the frequency of stool overflow.

3 Psychotherapy The purpose of psychotherapy is to clarify and change stress factors, or to change the patient's attitude towards stress factors. Such patients must first overcome psychological barriers, because patients with fecal incontinence are often worried that outsiders will know and are unwilling to get along with others. Some are ashamed to seek medical treatment and delay the disease. European and American countries have patient encouragement groups to help patients overcome their shyness. For patients with obvious psychogenic factors, systematic desensitization test can be used for treatment if necessary. In addition, patients can be asked to wear elastic tight pants to increase bowel control ability.

4 Pelvic floor muscle electrical stimulation Pelvic floor muscle electrical stimulation is used to induce anal ESA contraction to treat FFIC. The results of the efficacy reports in the literature vary greatly, and most people believe that it is ineffective.

5 Biofeedback therapy Biofeedback therapy is used to treat FFIC, mainly using electromyography biofeedback and anal pressure biofeedback. Anorectal function is analyzed through anorectal electromyography or manometry technology, and training methods are used to treat fecal incontinence. Each biofeedback treatment takes about 50 minutes, during which time 50 bowel training sessions are performed, 1 to 3 times a week, for 1 to 6 weeks. The length of the treatment is often determined based on individual circumstances and specific treatment effects. The effectiveness of biofeedback therapy for fecal incontinence is 50% to 90%. Long-term follow-up shows that most patients still maintain good spontaneous defecation more than one year after biofeedback therapy. Biofeedback therapy is painless, non-traumatic, has no adverse drug reactions, is not affected by factors such as the patient's age, has a high success rate and a low recurrence rate, and is a safe and effective method for treating FFIC.