The colon, rectum and anus store and eliminate faeces. In the normal person, emptying the back passage is a complex function that begins when lower bowel activity fills the rectum with faeces. This results in the sensation of needing to go to the lavatory. At this stage, voluntary straining and rectal contraction is co-ordinated with relaxation of the anus and a bowel motion is passed.
In CES, either of these functions may be affected independently, causing constipation, faecal incontinence, or a combination of both.
Lack of bowel control can have devastating effects upon the individual, lowering their self-esteem and confidence. Patients who have this problem may restrict their lives and become socially isolated. Constipation and faecal incontinence can also be a cause of ill health.
Patients with CES often have little or no gut activity in the rectum or have difficulty opening the back passage and have to use manual evacuation. Also, because there is numbness at the back passage and little or no desire to empty the bowels, it is necessary to check for the presence of stools. In addition, patients may also feel as if the rectum is full when in fact it is empty. In these circumstances patients can spend many frustrating hours straining unnecessarily. Damage to the nerve supply of the anal sphincters can also result in accidental faecal leakage or even permanent incontinence.
Establishing good routines from the start will help you in the long run. Make sure that you look at your bowel motions regularly, as it is possible to judge the amount that you pass and whether they are too loose or hard.
Any bowel management programme should be tailored to a patient's needs, abilities, lifestyle and the availability of help. Adequate fluid intake is important because dehydration can aggravate constipation. A balanced diet is essential and should contain daily portions of fruits and vegetables.
Page Last Updated: 10 June 2004