Introduction:
Pooping pants is a common term used for the condition fecal incontinence. It can also be called accidental bowel leakage. The condition is characterized by accidental passing of bowel substances such as solid stools, liquid stools or mucus from the anus. Fecal incontinence can be upsetting and embarrassing. Some people may feel ashamed and try to hide the problem. The condition is more common in older adults or adults admitted to hospitals and nursing homes. People with diarrhea, type-2 diabetes, irritable bowel syndrome or poor health are also prone to fecal incontinence.
What Are the Types of Fecal Incontinence?
The most common type of pooping pants condition is called urge incontinence. It is like having a very strong urge to have a bowel but could not stop it before reaching the toilet. In cases of urge incontinence, the pelvic floor muscles may be very weak to hold back a bowel movement because of muscle injury or nerve damage.
Another type of fecal incontinence is called passive incontinence. In these cases, the leakage occurs without even knowing. In cases of passive incontinence, the body cannot sense when the rectum is full.
In What Population Fecal Incontinence Is Common?
According to medical experts, fecal incontinence is a common problem affecting 1 in 3 people who visit a primary health provider.
It is common in adults who are admitted to hospitals or nursing homes for a long time.
Commonly seen in adults above 65 years of age.
Physiologically inactive individuals.
People with certain chronic diseases, health problems or medical problems.
Individuals with gallbladder removed due to some diseases or gallstones.
People who are frequent smokers.
Children with birth defects of spinal cord, rectum or anus are prone to fecal incontinence.
What Are the Complications of Pooping Pants?
People suffering from incontinence or pooping pants may also have problems such as:
Poor overall health due to uncontrolled bowel movement and upsetting mindset.
Diarrhea: Uncontrolled bowel movements with passing of watery stools.
Irritable Bowel Syndrome: It is a group of symptoms which occur together, including repeated pain in abdomen and changes in bowel movements leading to constipation, diarrhea or both.
Diseases or conditions affect the nerves of anus, rectum or pelvic floor.
Type-2 Diabetes: Increase in the blood glucose levels due to deficiency of insulin in the body.
Weakness or damage of the muscles and nerves of anus, rectum or pelvic floor.
Urinary Incontinence: Uncontrolled passing of urine.
Proctitis: A condition with constant urge to pass stool even when the bowel is empty.
What Are the Problems Caused by the Pooping Pants?
The problems caused by pooping pants or fecal incontinence are:
Irritation or discomfort of skin around the anus region.
Compromised quality of life issues such as being unable to work, exercise, attend school or visit social gatherings.
Emotional or social distance such as embarrassing fear, loss of self-esteem, social isolation, anger and depression.
What Are the Symptoms of Pooping Pants?
The symptoms of pooping pants depend on the type of incontinence:
In cases of passive fecal incontinence, the person passes the stool or mucus without knowing.
In cases of urge fecal incontinence, the patient will know the urge of passing stool but will not be able to control it before reaching the toilet.
Soiling: Streaks or stains of mucus or stool on the underwear.
What Are the Causes of Pooping Pants in Adults?
Fecal incontinence has several causes including some chronic diseases and digestive tract disorders.
Some of them are:
1. Diarrhea: Loose, watery stools which fill the rectum quickly and are harder to control than solid stools. Diarrhea is one of the common risk factors for fecal incontinence in people admitted in hospitals and nursing homes.
The causes of diarrhea can be:
Irritable bowel syndrome.
Inflammatory bowel disease.
Proctitis.
2. Muscle Injury or Weakness: If the muscles of the pelvic floor, anus or rectum are injured they may not be able to keep the anus sphincter closed and stool may leak out. The reason behind muscle injury or weakening could be:
- Surgeries include removal of cancer in the anus or rectum, hemorrhoids removal or treamtment of anal abscess and fistulas.
- Trauma due to accidents, sports or fights.
3. Nerve Damage: If the nerve tissue of rectum, anus or pelvic floor are damaged, the muscle may have an impaired function. This might make it difficult for muscles of these regions to hold the stool and give the signal to the brain when rectum is full.
The cause of nerve damage are:
Long-term straining habit to pass stool.
Spinal cord injury.
Brain injury.
4. Constipation: This can lead to large, hard stools which are very difficult to pass. These hard stools stretch and with time weakens the muscles in the rectum. These weakened muscles cause leakage of watery stools which build up behind the hard stool.
5. Neurological Diseases: These are the diseases which affect the nerves of the anus, pelvic floor or rectum and cause fecal incontinence.
These diseases are:
- Multiple Sclerosis: It damages the myelin sheath which surrounds the nerve cells and protects them.
- Dementia: Loss of mental functions that are severe enough to hinder daily activities.
- Parkinson’s Disease: It is a movement disorder caused due to lack of dopamine in the body.
- Type-2 Diabetes: Extreme high blood glucose levels can affect the nerves and lead to nerve damage.
- Stroke: Loss of blood flow to a part of the brain causing brain damage, long term disability or death.
6. Loss of Stretchability in Rectum: If the rectum is scarred or inflamed, it becomes stiff and cannot stretch enough to hold enough stool. This leads to early filling of rectum and leaking out of the stool.
7. Rectal Prolapse: Slipping down of rectum from the anus.
8. Childbirth by vagin*l Delivery: Childbirth in conditions such as large body size of baby, forcep use in delivery and use of vacuum in delivery can damage the anal sphincter leading to fecal incontinence.
How to Diagnose Pooping Pants?
- Medical History: A proper medical history along with physical examination is important.
- Lab Tests: It includes blood tests to look for signs of anemia, infection or inflammation. Stool test showing presence of blood or signs of infection in the stool. Urine test to check for type-2 diabetes.
- Bowel Function Test: One or more of the following tests are formed to see the functioning of muscles and nerves of anus, pelvic floor and rectum.
Anorectal Manometry: This test is performed to check the sensitivity of rectum and fucntioning of anal sphincter.
Defecography: X-ray the area around the anus and rectum to see how well the person can hold and release the stool.
Electromyography: Test to check the functioning of muscles and nerves of the anus and pelvic floor.
Endoscopy: It is performed to look for any signs of inflammation, or infection inside the anus, rectum, colon or digestive tract.
Endoscopes of fecal incontinence include:
Anoscopy
Colonoscopy
Flexible sigmoidoscopy
Rectoscopy
What Is the Treatment for Pooping Pants?
The treatment for pooping pants or fecal incontinence include management of the disease.
1. Absorbent Pads: Wearing absorbent pads inside the underwear is the most common treatment for fecal incontinence. With medical oversight, individuals can purchase absorbent pads.
2. Dietary Changes: Diet intake should be followed according to the underlying cause such as diarrhea or constipation.
3. Over-the-Counter Medicines: Depending on the cause, medicines can help cure fecal incontinence. If diarrhea is the cause, medicines such as Loperamide and Bismuth subsalicylate should be advised. Whereas in cases of constipation, laxatives, stool softeners, or fiber supplements such as psyllium should be advised.
4. Pelvic floor Muscle Exercise: It is also known as Kegel exercise. Tightening and relaxing pelvic muscles many times a day can strengthen the muscles of anus, pelvic floor and rectum.
5. Sacral Nerve Stimulation: Sacral nerves control the functioning of anal sphincters, rectum and colon. Doctors can use sacral nerve stimulation (electrical stimulation) to treat fecal incontinence.
6. vagin*l Balloons: For women with pooping pants, the doctor may suggest a device which inflates the balloon inside the vagin* which puts pressure on the rectal wall through the vagin*l wall.
7. Non-absorbable Bulking Agents: These are substances injected into the anus wall to bulk up the tissue around the anus. The bulkier tissue makes the anus opening narrower, so that the sphincter can close better.
8. Surgery: Surgery is opted when other options fail to stop fecal incontinence.
- Sphincteroplasty: It is the most common surgery for pooping pants which reconnects the separated ends of anal sphincter torn by child birth or another injury.
- Artificial Anal Sphincter: A cuff is placed around the anus and a small pump is implanted under the skin which can inflate or deflate the cuff. Inflating the cuff controls the path of the stool. This surgery is not recommended generally as it has side effects.
- Colostomy: In this surgery, the colon is brought through the opening in the abdominal wall and stools are collected outside the body in a bag. This is the last resort for the treatment of fecal incontinence.
Conclusion:
Pooping pants is a disorder in which a person has no voluntary control over bowel movements and may poop whenever there is urge. In this condition the voluntary sensations of external sphincter are suppressed. Treatment of the disorder is important as it becomes embarrassing for the person in social and personal life.
