Boniva (Ibandronae Sodium)
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ALZHEIMER’S DISEASE: INVOLUNTARY INCONTINENCE OF FAECES
This is always a serious problem, not only because it is so unpleasant for both sufferer and carer but also because in most cases it is treatable but this is not realized. By far and away the most common cause is constipation. This is true whether or not the person has been incontinent of solid motion or of more liquid stools. If someone doesn’t open their bowels for a long time the motion in the back passage can get very hard and it can dam back a long way, so much so that it can reach that part of the bowel where the motions are still liquid. This liquid motion then runs down the outside of the hard stool and leaks out as diarrhea. If the constipation is very bad the hard motion pushes down and keeps the anus open so that both solid and liquid stools keep being passed. At this stage the bowels must first be cleared with enemas or manually, and then a regular bowel habit arranged.
There may be a reason why the person has been trying not to open their bowels (apart from confusion and not finding a toilet). That is why when faecal incontinence occurs, all people must have their back passage examined by a doctor – a rectal examination, quick and straightforward. There may be a painful condition obvious, such as piles (hemorrhoids) or a fissure. In the latter condition a small crack appears at the opening of the back passage, it gets inflamed and then causes a lot of pain when a motion is passed; it can be helped with creams but often needs a small operation to cure it.
Sometimes the examination will reveal a growth in the back passage. These are often painless and cause trouble late in their development. In the early stages they may bleed a little or cause constipation and then diarrhea intermittently. If they cause faecal incontinence it is usually at a late stage. All growths in the back passage must be biopsied (a small piece of tumour taken for laboratory examination) and analyzed under the microscope to see if it is a cancer or not.
Drugs can also cause faecal incontinence. Liquid paraffin is still used as a softener and laxative, but the paraffin can leak out of the back passage and cause incontinence. Some laxatives stimulate the bowel and can be quite strong, causing coli«c and the sudden passage of a stool and hence incontinence, e.g. sienna preparations. Diarrhea is a potent cause of faecal incontinence because the person may get very little warning and be unable to hold on to the liquid. The following drugs are well recognized causes of loose motions:
Ђў Iron preparations
Ђў Laxatives
Ђў Antibiotics
Ђў White stomach medicine (magnesium hydroxide)
If none of the above conditions are found to bµ the cause of the faecal incontinence then the person should be seen by a specialist as there are some neurological causes that may respond to treatment. Specialized investigations are often performed and treatment plans given. Faecal incontinence must never be accepted and put down to either age or confusion.
*39/128/5*
