Fecal incontinence is the inability to control the passage of gas, mucus, or stool in a way that causes difficulty or distress for the patient—ranging from minor soiling of underwear to complete loss of control.
Beyond the physical issues, it carries a significant psychological and social burden, and the primary goal of treatment is to improve quality of life. Its true prevalence is higher than commonly assumed, because many patients do not report symptoms due to embarrassment.
This condition is more common in women (especially after vaginal childbirth) and in older adults, and mild cases often remain unreported.
Functional constipation or Obstructed Defecation Syndrome (ODS) refers to difficulty in completely emptying the rectum despite feeling the urge to defecate. The main symptoms include excessive straining, a persistent sensation of incomplete evacuation, and sometimes the need for manual assistance during defecation. The underlying causes may include pelvic floor muscle dysfunction or structural problems such as rectocele or intussusception. ODS is one of the important contributors to chronic constipation and is reported in 20–30% of constipated patients in some populations. This condition is more common in women (especially after childbirth) and in middle-aged and older adults.
Rectal prolapse is the abnormal protrusion of the rectum through the anus, which may involve only the mucosal layer or the full thickness of the rectal wall. A milder form, called internal intussusception, occurs when the rectum folds inward but does not protrude externally. This condition is more common in middle-aged and elderly women, as well as in young children. Contributing factors include multiple or complicated childbirths, chronic constipation, pelvic floor neurological disorders, connective tissue abnormalities, and a history of pelvic or anal surgery. Rectal prolapse can lead to difficulties with defecation and significantly impact quality of life.
A rectocele is a bulging of part of the rectum into the vagina caused by weakening of the wall between the rectum and the vagina (the rectovaginal septum).
It occurs only in women and is more common in middle age and after menopause. Many women have some degree of rectocele without noticeable symptoms. Risk factors include multiple vaginal deliveries, chronic constipation, obesity, and chronic coughing.
A cystocele is the descent or bulging of part of the bladder into the vagina due to weakening of the anterior vaginal wall.
It is common in women and becomes more frequent with aging and after vaginal childbirth. Many cases are detected on physical examination but do not always cause symptoms, and some patients may have no complaints at all.
Uterine or vaginal prolapse refers to the descent of the uterus or the vaginal apex into or outside the vaginal canal due to weakening of the pelvic support structures.
It may occur together with bladder or rectal prolapse and can affect sexual function, urination, and bowel movements, reducing overall quality of life. Prolapse is more common in women—especially after the age of 40–50—and many have some degree of prolapse without noticeable symptoms. Risk factors include vaginal childbirth, obesity, chronic constipation, and genetically weak connective tissue.
Perineal descent refers to excessive downward movement of the pelvic floor (the area between the anus and the genital region) during straining, causing the anorectal structures to drop below their normal position.
This condition can lead to difficulty with bowel movements, a sensation of incomplete evacuation, excessive straining, leakage of stool or gas, and a feeling of pelvic heaviness or bulging. It may also affect urinary function or sexual activity.Perineal descent is more common in middle-aged and older adults and occurs more frequently in women, especially after vaginal childbirth.Other risk factors include chronic constipation and straining, obesity, long-standing cough, connective tissue disorders, and nerve injuries or previous pelvic surgeries.
