Fecal incontinence is a big taboo subject in society.
Fecal incontinence is still a big taboo, and persons affected often hide their problems even from physicians. During a detailed anamnesis the physician should specifically inquire about previously existing diseases, operations, injuries, births, beginning of symptoms, defecation frequency, character of the feces, circumstances of involuntary defecation and previous therapies.
A patient diary facilitates diagnostic recording and monitoring of a therapy and provides a more objective overview of the symptoms.
During a clinical examination of the anal region the physician should pay attention to the following:
• Irritations • Inflammatory or ulcerous changes in the perineal skin • Fissures • Scars • Abnormalities • Fistula etc.
The anocutaneous reflex is examined through the digirectal examination to test the closing pressure of the sphincter. Additionally further examinations can be conducted additionally:
• Anorectal manometry (measures the function of the sphincter system and checks the therapeutic result). • Anorectal endosonography (identifies the structural damage and the degenerating illness of the sphincter musculature). • Procto- and rectosigmoidoscopy (benign or malignant stenosing disease as well as inflammations of the mucous membrane are diagnosed as possible triggers).
Defecography is used to examine defecation in an X-ray test. This procedure is however not used regularly. The physician can measure the sphincter function by means of pelvis floor electromyography.
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