Gas incontinence occurs when excessive consumption of foods that increase gas formation. Normally, the symptom occurs in older people. Pathological causes of uncontrolled release of intestinal gases: insufficiency of the obturator function of the anal sphincter, other proctological diseases, intestinal diverticula, CNS diseases. For diagnostic purposes, functional tests, sigmoidoscopy, X-ray examination are carried out. Women are required to see a gynecologist. For treatment, diet therapy, physiotherapy techniques are used. Less often resort to surgical methods of correction of the sphincter ring.
Increased gas formation and, as a result, difficulties with holding gases are provoked by the use of a large amount of legumes, cabbage and radishes, whole grains. Enhanced gas formation is caused by fruits: pears and apples, grapes, peaches. If gas incontinence is caused by nutritional factors, the symptom occurs 1-2 hours after eating. In the morning before breakfast, bloating is not observed.
Flatulence (gassing), which occurs in old age, is a variant of the norm. Incontinence is associated with age-related weakening of the muscular apparatus of the anal sphincter. The problem is aggravated by a lack of digestive enzymes, which causes partially digested food to accumulate in the intestines, leading to increased gas formation.
With IBS, intestinal motility and coordination of the work of the muscular sphincters of the rectum are disturbed. The disease is characterized by gas incontinence without bloating. The patient is not able to control this process, sometimes a person learns about an unpleasant situation only when a specific smell appears. Less commonly, flatulence develops against the background of severe pain in the rectum. Typically worsening of symptoms in the morning, improvement after defecation.
Isolated gas incontinence is characteristic of the first degree of the disease, when the act of defecation is not yet violated. At the second stage of insufficiency, the separation of not only intestinal gases, but also liquid feces is not controlled - the so-called "wet anus". At the third degree, the patient does not hold gases, liquid and formed feces. Incontinence and other symptoms are not related to dietary habits. The failure of the anal sphincter is provoked by the following diseases:
With intestinal diverticulosis, increased gas formation is constantly observed, which inevitably leads to flatulence. Diverticula are characterized by rumbling in the abdomen and passing gases with a sharp unpleasant odor. The condition is aggravated by errors in the diet. With diverticulosis, incontinence is also accompanied by pain and cramps in the abdomen, irregular stools like “sheep feces”.
Pathologies of the internal genital organs are the main cause of gas incontinence in gynecological practice. Symptoms are due to the proximity of the organs of the gastrointestinal tract and the genitourinary system, their joint innervation. Incontinence is more often determined in women after 5 years, but it can also disturb patients of reproductive age after multiple births. The main diseases in which gas incontinence is possible:
Flatulence is associated with damage to the parts of the spinal cord, which are responsible for the innervation of the rectum and anal sphincters. Less often, incontinence is caused by damage to certain areas of the brain. Uncontrolled passage of gases is combined with involuntary discharge of feces and urine. A similar clinical picture is observed with injuries of the spine and head, demyelinating diseases.
In patients with mental disorders, control over the discharge of gases is lost. In this case, the disorder develops during normal bowel function and does not depend on the diet. The symptom is most characteristic of senile dementia, schizophrenia, bipolar disorder. Sometimes gas incontinence worries patients with neurosis, post-stress psycho-emotional disorders. The condition is completely normalized after the elimination of the stress factor.
During a physical examination, the proctologist draws attention to the gaping of the anus, with fecal incontinence, maceration of the skin around the anus is observed. To assess the closing function of the sphincter and identify signs of pathology of the rectum, a digital rectal examination is performed. To diagnose the causes of gas incontinence, the following laboratory and instrumental studies are used:
All patients who are concerned about gas incontinence are prescribed conservative measures that are aimed at reducing gas formation in the intestine. Exclude foods that cause flatulence from the diet. It is necessary to eat small meals 4-5 times a day. While eating, it is important to chew food thoroughly, avoid aerophagy (swallowing air). To reduce gas formation, it is necessary to stop smoking and chewing gum.
Treatment depends on the cause of gas incontinence. With functional disorders (IBS), it is necessary to eliminate stressful and provoking factors, to carry out diet therapy. With hemorrhoids, electrocoagulation, sclerotherapy of hemorrhoids, ligation with latex rings are performed. To eliminate the insufficiency of the sphincter apparatus, drugs are shown that increase the excitability of nerve endings.
With functional insufficiency of sphincters, physiotherapy is effective. To increase the tone of muscle fibers, electrical stimulation is useful. A promising direction of therapy is the method of biofeedback. The essence of the technique is to train the muscles of the pelvic floor and anus, which allows the patient to control the release of gases. Special exercise therapy complexes are also prescribed.
In case of severe damage to the anal sphincter, surgeons perform plastic surgery: sphincteroplasty or sphincterolevatoroplasty. After interventions, as a rule, the obturator function of the anus improves. With the ineffectiveness of these methods, a new sphincter apparatus is formed. With anorectal defects, various methods of their surgical correction are used.
Gas incontinence, which develops with gynecological diseases, disappears after resolving issues with the underlying disease. Women undergo surgery to strengthen the muscles of the pelvic floor. In case of serious pathologies, a combined surgical treatment is performed, which involves fixing the uterus, plastic surgery of the vagina and strengthening the musculoskeletal apparatus.