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Concept
Incontinence fécale
Résumé
Fecal incontinence (FI), or in some forms encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents, both liquid stool elements and mucus, or solid feces. When this loss includes flatus (gas), it is referred to as anal incontinence. FI is a sign or a symptom, not a diagnosis. Incontinence can result from different causes and might occur with either constipation or diarrhea. Continence is maintained by several interrelated factors, including the anal sampling mechanism, and incontinence usually results from a deficiency of multiple mechanisms. The most common causes are thought to be immediate or delayed damage from childbirth, complications from prior anorectal surgery (especially involving the anal sphincters or hemorrhoidal vascular cushions), altered bowel habits (e.g., caused by irritable bowel syndrome, Crohn's disease, ulcerative colitis, food intolerance, or constipation with overflow incontinence). An estimated 2.2% of community-dwelling adults are affected. However, reported prevalence figures vary. A prevalence of 8.39% among non-institutionalized U.S adults between 2005 and 2010 has been reported, and among institutionalized elders figures come close to 50%.
Fecal incontinence has three main consequences: local reactions of the perianal skin and urinary tract, including maceration (softening and whitening of the skin due to continuous moisture), urinary tract infections, or decubitus ulcers (pressure sores); a financial expense for individuals (due to the cost of medication and incontinence products, and loss of productivity), employers (days off), and medical insurers and society generally (health care costs, unemployment); and an associated decrease in quality of life. There is often reduced self-esteem, shame, humiliation, depression, a need to organize life around easy access to a toilet, and avoidance of enjoyable activities. FI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse.
Source officielle
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Concepts associés (27)
Prolapsus rectal
thumb|Prolapsus rectal Le prolapsus rectal est une pathologie causée par des distensions du rectum et induisant une difficulté à contrôler les défécations, et pouvant aller jusqu'à l'incontinence anale. Ces distensions sont provoquées en particulier lors de l'évacuation des selles : le rectum sort alors légèrement à travers l'anus, d'où la justification de l'étymologie latine « pro-lapsus », soit « glissement en avant ».
Rectum
Le rectum est le dernier segment du tube digestif reliant le côlon sigmoïde à l'anus. Il est composé de deux parties distinctes : l'ampoule rectale qui permet le stockage des matières fécales en attente de la défécation (réservoir), et le canal anal qui permet la continence. Notons que pour certains auteurs, le canal anal ne fait pas partie du rectum et est donc indépendant. Le substantif masculin « rectum » () est attesté dès le : d'après le Trésor de la langue française informatisé, sa plus ancienne occurrence se trouve dans la la de Guy de Chauliac, achevée vers .
Anismus
Anismus or dyssynergic defecation is the failure of normal relaxation of pelvic floor muscles during attempted defecation. It can occur in both children and adults, and in both men and women (although it is more common in women). It can be caused by physical defects or it can occur for other reasons or unknown reasons. Anismus that has a behavioral cause could be viewed as having similarities with parcopresis, or psychogenic fecal retention. Symptoms include tenesmus (the sensation of incomplete emptying of the rectum after defecation has occurred) and constipation.