Anal leakage is characterised by the faeces and stools coming out of the body of the Anal cavity without the willingness of the person. Sometimes, this happens without anybody stimulus. Usually, the bowel movement is dependent on the urge of the person to release bowel, but in particular people, they lose the control over it, expulsion occurs before reaching a toilet. (1)

Anal Leakage in some people is a temporary problem while for some it often happens and without any control. It is essential for the person suffering from this, to take this problem seriously and discuss openly with the physician and get proper treatment for the cause.

Anal leakage or faecal incontinence is a physical and a psychosocial disorder which negatively affects the quality of life of an affected person. It is a burden not only for the patient but also makes it difficult for the family members. Especially in case of women, it is tough to discuss the problem openly. (2)

Anal leakage is found in both men and women; however, the incidents of anal leakage are higher in case of women. In a study, it was found that 19% of the women were suffering from this problem.

Anal leakage in many occurs due to the inability of the muscles to contract and dilate the sphincters. Anal leakage causes varying degrees of symptoms in various people. If anal leakage is not treated on time, it leads to social non-acceptance and embarrassment for the person.

Causes of anal leakage are:

Diarrhoea:

It is mostly caused by an infection which may be bacterial or viral. This is also a result of gastroenteritis or food poisoning.

Constipation:

Constipation can also lead to anal leakage. Constipation makes the colon to lose its strength. This causes the liquid in the stool to leak outwards.

Muscle Problems:

The sphincters are controlled by many different muscles and nerves. They help the muscles in contraction and relaxation to release the stool. In many cases, muscles don’t have the strength to control the rectal muscles.  The muscle weakness occurs because of haemorrhoids, childbirth or any muscular disease.

Nerve Problems:

Anal sphincters respond to the nerve stimuli. The nerves get damaged due to neurological diseases like diabetic neuropathy, stroke or MS (multiple sclerosis). Nerve damage can also occur due to pressure applied during childbirth or while pushing bowels.

Rectal stiffening:

Stiffening of rectum affects the ability of the rectum to work correctly leading to the leakage of smaller faeces. This rectal damage occurs due to a rectal disease or in case of IBD (inflammatory bowel disease)

Rectal Prolapse:

Rectal prolapse causes the rectum to protrude. It can lead to fluid leakage referred as rectal leakage

Anal cancer:

Cancer leads to unresponsive nerves and muscles. This can result in anal seepage.

Other causes of the anal leakage include:

• GE or Gastroenteritis
• Prolonged constipation
• Haemorrhoids
• Gynaecological disorders
• Anal fissures
• Rectal ulcers
• Nerve disorders etc.

Signs and symptoms of anal seepage:

Some of the symptoms of anal leakage include:

• Itching or Pruritus around Anus
• Itching or pruritus over Buttocks
• Burning sensation in anus
• Pain
• The urgency to pass faeces even after passing stool
• Problems like constipation or diarrhoea (3)

Diagnosis of Anal Leakage:

Diagnosis of anal leakage includes following points:

Patient evaluation:

A Proper study of the aetiology of the patients helps to evaluate the severity and the cause of the problem. Physiological tests of the person include knowing the history of the person, his dietary habits as well as covers physiologic, neurologic and anatomic studies

Anorectal examination:

This helps to examine the factors like haemorrhoids fissures, fistula or abscess.

Physiological examination:

This is required in some instances where physical examination or anorectal examination does not give concluding evidence. This includes:

Anorectal Manometry:

This helps to detect the pressures the anal sphincters exert during compression and relaxed state.

Pudendal Nerve Terminal motor Latency:

Pudendal nerve helps in controlling the anal sphincter and puborectalis muscle. This test helps to calculate the time required for the stimuli to reach from the pudendal nerve to the anal sphincter.

Anal endo-sonography:

This helps to take the high-resolution images of the anal canal using a rotating endoprobe. This helps in detecting the problem related to Sphincters

Endoluminal MRI:

It is the visualisation of the normal anatomy and pathologic conditions of the anal canal. Lesions or scar on the outer sphincters can be quickly analysed using this test (4)

Treatment of Anal Leakage:

Anal leakage is a massive embarrassment for the person and needs to be discussed and treated. Treatment of this can be done using various factors which includes changes in lifestyles, modifying the eating habits. The inclusion of herbal substances in the diet can also help reduce anal leakage. Some of the treatment ways include:

Drinking lots of Water:

Water intake can help to cure and restore most of the body functions especially the ones related to the bowel. Water helps to improve the digestive system. It is recommended to have at least eight ounces of water every day to keep a healthy digestive system

Eat fibrous food:

Fiber helps in maintaining the proper functioning of digestive system. Fibre helps in keeping the stools soft and also helps in treating constipation. A person suffering from Anal Leakage should include a right quantity of fibre in the daily diet. It is recommended to have grains, nuts, and berries in the food.

Chamomile tea:

It is an ingredient which helps to keep the digestive system as well as the brain healthy. Chamomile has an excellent property of keeping the muscles relaxed. Thus it helps in keeping the anal and rectal muscles comfortable and prevents anal leakage.

Lifestyle changes:

Many of the problems can be solved by making lifestyle changes to your routine. Some of the lifestyle changes that should be incorporated into daily life include:

Drinking plenty of water:

One should drink a lot of water to maintain proper bowel movement

Avoid milk:

People suffering from anal leakage should reduce the use of Lactose containing products as Lactose induces diarrhoea.

Avoid spicy food which irritates bowel:

Spicy and fried food should be avoided as it results in irritation to the anus and cause bowel irritation.

Caffeinated beverages:

Beverages containing caffeine should be avoided as they cause damage to rectal nerves and muscles.

Probiotics:

Probiotics help in reducing anal leakage and also helps in the treatment of diarrhoea as well as constipation. Research done on probiotics has proven their positive effects on diarrhoea are happening due to the use of antibiotics or a bacterial infection.

Ginger:

Ginger is an excellent natural herb; the roots of ginger can be used efficiently for many digestion-related disorders. Ginger is used for treating numerous stomach problems like the stomach cramp, inflammation etc.

Ginger supports many normal body functions. The use of Ginger has been found useful to reduce symptoms of Anal Leakage. One of the ways of using ginger root is to use as a ginger tea. Ginger should be put in boiling water to harness its positive effects.

As there are varied causes of anal leakage, so in case of chronic anal leakage, it is essential to consult a doctor. The longer this condition is untreated, the difficult it would be to treat. (5)

Some of the medications used for the treatment of Anal Leakage include:

Faecal Incontinence: These include the drugs to treat diarrhoea (antidiarrheal drugs), laxatives, enemas for faecal impaction, proper diet and exercises

Haemorrhoids: Haemorrhoids another leading cause of Anal Leakage can be treated using hydrocortisone ointments and other local applicants, Oral pain relievers, Sitz bath and lifestyle changes can help cure haemorrhoids.

Gastroenteritis: This can be treated by using the proper medicinal course for treating bacterial infection. This includes rehydration, anti-diarrheal drugs and antibiotics.

Constipation: Constipation can be treated by modifying the diet of the person, the inclusion of fibre supplements in the food, stool softeners and laxatives. Proper exercise also helps in relieving constipation.

Inflammatory Bowel Disease: It is another cause of Anal Leakage. This symptom of the Anal Leakage can be treated using certain medicines such as Anti-inflammatory drugs, immune system suppressants, anti-diarrheal medications, pain relievers and antibiotic.

Irritable Bowel Syndrome: This can be treated by including a host of changes in lifestyle and medications. Lifestyle changes include the inclusion of fibrous products in the diet, specific exercises, modifying the eating habits and restricting some foods in the diet.

While the medication to treat Irritable Bowel Syndrome includes Antidiarrheal drugs, laxatives, antispasmodic medications, drugs to slow the movement of bowel, antibiotics to cure the infection and antidepressants as mood stabilisers.

It is a disease which can hamper the social life of the person, so it is essential to discuss the problem with a physician and then undergo treatment for the cause.

References:

1. Belmarrahealth
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394646/
3. Healthhype
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711681/
5. Healthyandnaturalworld

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