incontinence
Introduction
Introduction Fecal incontinence: When the patient's anal sphincter loses control, the bowel movement is no longer dominated by will and will defecate without any awareness. Urinary incontinence: urine loses will control and does not flow freely is urinary incontinence. With age, incontinence becomes more and more common, because the muscles, ligaments, and tissues that keep the bladder and intestines tight are weakened and function declines. Paying attention to the child's toilet training is the basic measure for prevention.
Cause
Cause
Cause:
1. With age changes, incontinence becomes more and more common, because the muscles, ligaments, and tissues that keep the bladder and intestines tight and weaken and function gradually decline.
2, stress incontinence: almost one-fifth of women over the age of 40 have experienced this type of incontinence, which is due to increased pressure in the abdomen, bladder sphincter and pelvis can not maintain the tightness of the bladder. Stress incontinence usually occurs when a person laughs, coughs, sneezes or sports.
3, bladder allergy: If the bladder muscles appear uncontrolled convulsions, the bladder will suddenly take the time to cause incontinence. This is also the bladder allergy we often say.
4, severe constipation: because the feces block the intestines, when the laxative drug passes through the blocked position, it will cause incontinence diarrhea.
5, infection: kidney or urinary tract infections will affect the normal control of the bladder.
6, nerve tissue damage: due to damage to the nervous system can also cause incontinence, such as spinal cord damage or some diseases such as multiple sclerosis.
7. Disease: Disease not only impairs human function but also increases the risk of incontinence. Rectal or anal tumors can cause fecal incontinence.
Examine
an examination
Related inspection
Defecation angiography examination of anus finger examination bladder ultrasound
Incontinence check:
(1) Anorectal manometry: including the resting pressure controlled by the internal anal sphincter, the maximum pressure at the time of external contraction of the external sphincter, and the threshold of stimulation at the time of diastole. Anal resting pressure and maximum pressure are reduced during fecal incontinence.
(2) Electromyography: It is an objective basis for reflecting the physiological activities of the pelvic floor muscles and sphincters to understand the location and extent of nerve and muscle injuries.
(3) Defecation angiography: The dynamic changes during defecation can be recorded, and the state of the puborectal muscle and the degree of injury can be estimated by the change of the rectal angle.
(4) Saline enema test: 1500ml of normal saline was injected into the rectum by sitting, and the leakage and maximum retention were recorded to understand the self-control ability of defecation. When the stool is incontinent, the amount of retention decreases or is zero.
(5) Anal canal ultrasound: The thickness of the internal sphincter can be accurately determined by accurately determining the location and asymmetry of the anal sphincter defect.
(6) renal function test, bladder ultrasound.
Diagnosis
Differential diagnosis
Fecal incontinence is mainly differentiated from occasional stool loss in patients with diarrhea such as acute bacillary dysentery and acute enteritis, but the stool of these patients can be controlled freely in most cases, and patients often have abdominal pain and pus and bloody stools or watery stools after symptomatic treatment. With the relief of diarrhea symptoms, stool formation, and occasional fecal incontinence disappeared.
