Uncontrollable defecation: What tests and scans need to be done to evaluate and diagnose

The article is professionally consulted by Gastroenterologist - Department of Examination & Internal Medicine - Vinmec Hai Phong International General Hospital

Incontinence, also known as fecal incontinence, is a condition in which a person cannot control his or her bowel movements. Feces from the rectum leak out when the patient participates in physical activities, strenuous activities, even at rest, with no or very little feeling of straining.
Although it does not have a great impact on health, uncontrolled defecation causes many inconveniences and discomforts to patients. If bowel incontinence is mild, with a small amount of stool, mainly only dirtying underwear, most patients can accept it. But if defecation is not completely controlled, the amount of stool that comes out will greatly affect the patient's physical and mental health.
There are many causes that can cause uncontrolled defecation such as:
U compressing the spine. Obstetric trauma and operations involving cutting or relaxing the sphincter. Weakness of the muscles that control bowel movements. Radiation therapy to the pelvis, abdomen, rectum, or genitals. Pelvic surgery. Constipation or diarrhea, irritable bowel syndrome. Severe depression. Hemorrhoids. Rectal prolapse. Uncontrolled diabetes. Nerve damage from stroke, spinal cord injury, dementia, Parkinson's disease, multiple sclerosis. Some drugs, vitamins, functional foods.

To diagnose and evaluate incontinence, your doctor will ask about your symptoms and do a complete physical exam (with a big focus on the anorectal area).
Patients need to tell the doctor about their diet and medications, especially antacids, laxatives and herbal supplements.
To assess the strength of the anal muscles and detect abnormalities, the doctor may perform a direct rectal exam by wearing gloves, then insert a lubricated finger into the rectum to examine .
Besides, to accurately diagnose and evaluate the condition of bowel incontinence, some other tests and imaging techniques may be ordered, including:
Blood tests: Some blood tests baseline will be indicated for the general assessment of health status. Stool test: A small stool sample will be tested for signs of infection. Abdominal X-ray: Your doctor may use X-ray films to detect hard stools in the intestines.

Anorectal manometry: This technique is used to assess the pressure in the anal canal, rectum, and strength of the anal muscles. Endoanal ultrasound: An ultrasound probe is inserted into the anus and rectum, the resulting images will be displayed on the screen to help the doctor detect lesions and abnormalities in the posterior sphincter. subject. Colonoscopy: A flexible tube with a camera is inserted through the anus through the rectum into the colon to detect areas of inflammation, bleeding, ulcers, tumors, and polyps. Anal electromyography (EMG): A needle electrode is inserted directly into the anal muscle tissue. The electrical signals obtained help the doctor assess the health of the anal sphincter, pelvic floor muscles, and general control nerve cells. Contrast X-ray: Contrast is injected into the rectum, then X-rays are taken. Thanks to the contrast agent, X-ray images will appear very clearly, helping the doctor to detect abnormalities of the large intestine and rectum. Magnetic resonance imaging (MRI) of bowel movements: Magnetic resonance imaging produces detailed images and information about the pelvic floor and rectum, and how these organs function during defecation. During the examination, images will be recorded at different stages of defecation such as rest, straining, and defecation. This allows assessment of pelvic floor muscle activity during defecation and helps assess the anatomy and function of the pelvic floor muscles.

Treatment of fecal incontinence depends on the cause.
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Reference source: radiologyinfo.org