Anal, or faecal incontinence is the inability to control bowel movements, leading to faeces unexpectedly leaking from the rectum.
Anal incontinence affects more women than men, however affects both sexes more equally with increasing age. Women can be affected by anal incontinence after childbirth, particularly as a result of a complicated delivery which probably required the use of forceps or an episiotomy.
In the elderly anal incontinence can develop when muscles become weak and the supporting structures in the pelvis become loose.
Incontinence can also occur as a result of muscle damage from rectal surgery. For example, some people who have previously undergone surgery to treat haemorrhoids. It can also develop in people who are suffering from inflammatory bowel disease.
Damage to the nerves that regulate rectal sensation and control the anal muscle is another cause. In addition to childbirth, nerve damage can occur with severe and prolonged straining when using the toilet, and as a consequence of some diseases- for example diabetes, multiple sclerosis and spinal cord tumours. Loss of storage capacity in the rectum is another factor.
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Mr Bruce Sutherland CBE. June 2011