ANAL INCONTINENCE

Continence of anal canal is maintained by two factors:

- Normal rectal and colonic pressure and activity.

- Normal pelvic floor function.

TYPES:-

- Urge incontinence—here rectal and colonic pressure and activity is increased but normal pelvic floor.

- True incontinence—here rectal and colonic pressure and activity is normal but defective pelvic floor function.

- Full incontinence—here rectal and colonic pressure and activity is reduced and also defective pelvic floor function.

- Temporary—treated by reassurance. Often seen after Lord’s dilatation.

- Permanent—needs definitive therapy.

CAUSES:-

Causes of anal incontinence

- Denervation—spinal injury, spina bifida.

- Damage—childbirth, wounds, surgeries

- Descent—rectal prolapse, perineal descent

- Debility—old age, diseases

- Destruction—RT, malignancy

- Dementia—senility, psychosis

- Deficiency—congenital anomalies

- Irritable bowel syndrome, severe diarrhoea.

- Prolapsed piles, rectal prolapse.

- Old age, malnutrition, debilitating illness.

- Congenital anomalies.

- Trauma, surgeries, injury during childbirth in females.

- Spina bifida, spinal tumours, spinal injuries and surgeries.

- Malignancy, postirradiation.

- Psychological causes.

Evaluation of the patients:-

• For specific cause.
• Anorectal manometry.
• Per-rectal examination
• Sigmoidoscopy
• Electromyography
• Defaecography
• Perineometer to assess level and angle of anorectal junction.

HOMEOPATHIC MANAGEMENT:-

The medicines that can be thought of use are:-

• Aloe soc
• Podophyllum
• Causticum
• Hyoscyamus
• China