Fecal incontinence is an invisible pathology, which limits the lives of people who suffer from it in all spheres. From the social level, to the work or sexual level, in general people live in silence due to shame, fear, or lack of knowledge, both on the part of the patient who suffers from it and many professionals who do not know how they can help them.
Specifically, two to four million Spaniards suffer from it, disabling them without being able to control the involuntary release of fecal content and gases. In fact, Dr. Laura Lázaro, a surgeon specializing in Coloproctology, from the Surgical group at the Dexeus University Hospital in Barcelona, explains that fecal incontinence is common in our environment, it affects the population of all ages, and with a greater frequency than expected. It is thought, although it mentions that its causes can be very diverse.
“It affects women over 50 years of age more and is associated with different risk factors, such as parity, instrumental deliveries, chronic diarrhea and constipation; and to different types of treatments, such as pelvic surgery, prostate or female genital radiotherapy; hemorrhoids or rectal prolapses; neurological diseases such as dementia, multiple sclerosis or Parkinson's, or in some cases degenerative diseases in patients admitted to nursing homes,” he maintains.
In this sense, the Spanish Association of Coloproctology (AECP) details that the causes of fecal incontinence are usually “multiple” and are generally attributed to cases in which a rupture of the muscles surrounding the anus occurs or due to a nerve injury in the anus. said area, and which could have taken place during trauma, childbirth, or after surgery; while pointing out that although these muscles are not broken, they may have lost their functions due to age or injuries.
This is why the surgeon specializing in Coloproctology, from the Surgical group of the Dexeus University Hospital, sees it as important to raise her voice to make this pathology known, as well as convey that it has a solution.
“As surgeons specialized in the digestive system, our goal is to help these patients find solutions to improve their quality of life. It is a problem that limits the lives of patients, to a large extent, both from a social, work and relationship point of view," explains Dr. Laura Lázaro.
From the Coloproctology Unit of the Dexeus University Hospital they have been working for more than 10 years diagnosing, treating and helping to improve the quality of life of patients with incontinence. "The joint study with different professionals is essential for the success of the treatment," highlights this specialist.
And, as he warns, the health expenditure incurred is “high”, which is why he considers that it could be improved with preventive treatments in people at risk, with the use of antidiarrheal drugs or laxatives as needed by the patient; as well as if the number of affected people is reduced through pelvic floor rehabilitation treatments, through physiotherapy; apart of course from patients improving dietary habits for mild cases.
But there are also cases in which surgery is necessary, when the previous measures fail, according to this coloproctologist, and these are usually cases with moderate to severe incontinence. ”That is when we perform reparative and/or reconstructive surgeries. In any case, the approach is always multidisciplinary and requires a high level of specialization.”
In addition to medical treatment and reconstructive surgery, there are others that are still little known, such as biomaterial implantation or neuromodulation, which is performed in the operating room and can be performed either from the peripheral point of view, neuromodulating the posterior tibial nerve, or from the view of the central nervous system through neuromodulation of sacral roots. "They are techniques that give very good results and that for patients mean recovering their quality of life," says Dr. Lázaro.
Precisely, the Association for Anal Incontinence (ASIA) works to raise awareness in society about this pathology and the emotional problems that suffering from it can cause. There are times when a person can become depressed since, according to its president Àngels Roca, "it is a disabling pathology until you find your solution."
Furthermore, in his opinion, the problem of incontinence is aggravated because the patients themselves do not know which professionals to go to, and in many cases they do not know the diagnosis or the treatment if they are not in specialized units.
For this reason, Dr. Laura Lázaro, a surgeon specializing in Coloproctology, from the Surgical group of the Dexeus University Hospital in Barcelona, encourages all these patients to go to doctors who are specialists in the field, experts in finding solutions for this problem that so affects the patients' lives.
