Anal sphincter insufficiency

The insufficiency of the anal sphincter is manifested by a complete or partial violation of the voluntary retention of the contents of the rectum (gases or feces). Often it is combined with a related symptom – the inability to control the act of urination, since the nervous regulation of both processes occurs with the participation of similar nerve centers.
Fecal incontinence is most often not an independent disease, but only a manifestation of other pathologies. This pathology does not threaten the patient's life, but significantly worsens the quality of life, as it creates many problems for the patient and the people around him. You can face this problem at any age.

As a rule, the insufficiency of the anal sphincter occurs as a result of 2 groups of causes: 

  • group 1: against the background of diseases related to the digestive tract and excretory system (rectal prolapse, injuries of the anus, accumulation of a large amount of solid feces in the rectum).
  • group 2: against the background of other diseases (birth injuries of the pelvis, tumors of the anus, neurological consequences of severe forms of diabetes, etc.)

In practice, fecal incontinence is usually divided by severity:

  • I degree-manifests itself in incontinence of gases.
  • Grade II-characterized by incontinence of unformed fecal masses.
  • III degree-is expressed in the inability of the patient to retain dense fecal masses.

Diagnosis of fecal incontinence is based on:
- assessment of patient complaints;
- examination of the patient with a finger examination;
- rectoromanoscopy - examination of the rectum using an endoscopic device;
- physiological methods of research to clarify the nature of changes and the degree of weakness of the pelvic floor muscles: sphincterometry, electromyography, anorectal manometry.
- electromyography of the pelvic floor muscles and rectal muscles in order to determine the correct functioning of the nerves that control these muscles.

The question of the volume of diagnostic examinations and treatment of fecal incontinence is very important and is prescribed individually after a visit to the doctor.

Treatment depends on the cause that led to this pathology, the degree of violation of the function of the pelvic floor muscles, the patient's condition and his age. Surgical and conservative methods of treatment of fecal incontinence are used.

Conservative methods include: 

  • diet therapy;
  • normalization of stool consistency;
  • a set of physical exercises aimed at strengthening the pelvic floor muscles.
  • instrumental methods of treatment - biofeedback method (biofeedback, BOS) – a modern highly effective non-drug method, which uses a combined effect of training methods aimed at improving the tone of the pelvic floor muscles. During the sessions, patients are trained to control changes in the state of the pelvic floor muscles. 

Electrostimulation is also used, in which there is an active effect on the locking apparatus of the rectum and increases the tonic tension of the muscles. The need and method of surgical correction is decided together with the proctologist surgeon after the patient's further examination 

Do not delay your visit to the specialists of our Center. This will help to diagnose this condition in a timely manner and choose the right treatment tactics. Doctors of the State Medical Institution of the Moscow State Medical Center named after A. S. Loginov DZM are always ready to help you. 

GBUZ Moscow Clinical Scientific Center named after Loginov MHD