Fecal Incontinence: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Absence of angulation (kinking) of the colon.
  • Anal atresia – lack of anoderm (anal mucosa) leads to limited sensitivity at the anus, which can lead to overflow incontinence

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Diabetes mellitus
  • Fructose intolerance (fruit sugar intolerance)
  • Lactose intolerance (lactose intolerance)
  • Sorbitol intolerance

Cardiovascular system (I00-I99)

  • Apoplexy (stroke) – 50-70% are fecal incontinent.
  • Hemorrhoids
  • Central hemorrhage – bleeding in the brain, unspecified.

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

  • Anal prolapse (synonym: hemorrhoidal prolapse; anal prolapse).
  • Colitis indeterminata – chronic inflammatory bowel disease (IBD) that does not allow a reliable differentiation into ulcerative colitis or Crohn’s disease.
  • Ulcerative colitis – inflammatory bowel disease (IBD).
  • Diarrhea (diarrhea) – can lead to symptomatic fecal incontinence.
  • Diverticulitis – disease of the colon in which inflammation forms in protrusions of the mucosa (diverticula).
  • Fistula – non-physiological connection between two cavities.
    • Enterocolic – connection between small and large intestine; can lead to symptomatic fecal incontinence
    • Rectocutaneous – connection between the rectum and the skin.
    • Rectovaginal – connection between the rectum and the vagina.
  • Generalized pelvic floor insufficiency (pelvic floor weakness).
  • Infectious colitis – inflammation of the intestine caused by bacteria, viruses or parasites such as salmonella.
  • Intraanal condyloma
  • Microscopic colitis or microscopic colitis (synonyms: Collagenous colitis; collagen colitis, collagen colitis) – chronic, somewhat atypical colonic mucosal inflammation, the cause of which is unclear and which is clinically accompanied by violent watery diarrhea (diarrhea)/4-5 times daily, including at night; some patients suffer from abdominal pain (abdominal pain) in addition; 75-80% are women/females > 50 years of age; correct diagnosis is only possible with colonoscopy (colonoscopy) and step biopsies (taking tissue samples in the individual sections of the colon), i.e. i.e. by a histological (fine tissue) examination to put.
  • Crohn’s disease – chronic inflammatory bowel disease (CED); usually runs in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, it may be affected several intestinal sections that are separated by healthy sections.
  • Constipation (constipation) with / without stool impaction / fecal stones.
  • Post cholecystectomy diarrhea – occurrence of diarrhea after surgical removal of the gallbladder.
  • Pseudodiarrhea – pseudodiarrhea is when there is only an increased frequency of stools, but the stool weight is normal; this occurs primarily in irritable bowel syndrome
  • Proctitis – inflammation of the rectal wall.
  • Irritable bowel syndrome (colon irritable) – functional bowel disorder in which no causative disorders can be found.
  • Rectal prolapse (rectal prolapse).
  • Rectal ulcer (rectal ulcer)
  • Radiation colitis – inflammation of the large intestine, which can occur after radiation, especially in the context of cancer therapy.
  • Radiation proctitis – inflammation of the rectal wall, which can occur after irradiation, especially in the context of cancer therapy.

Musculoskeletal system and connective tissue (M00-M99).

Neoplasms – tumor diseases (C00-D48).

  • Anal carcinoma – cancer of the anus
  • Brain tumor, unspecified
  • Rectal carcinoma – cancer of the rectum.

Psyche – nervous system (F00-F99; G00-G99)

  • Herniated disc
  • Conus cauda syndrome – neurological disorder caused by injury to the cauda equina (nerve fibers at the end of the spinal cord), with flaccid leg paralysis, breech anesthesia, bladder and rectal dysfunction
  • Dementia, unspecified – > 70% are fecal incontinent.
  • Brain organic psychosyndrome (HOPS) – mental disorders that may occur with diffuse brain damage.
  • Meningomyelocele – protrusion of a section of the spinal cord (myelon) along with the meninges (meninges) due to a defect in the spinal column.
  • Alzheimer’s disease
  • Multiple sclerosis (MS) – chronic disease that can lead to paralysis.
  • Multiple system atrophy (Shy-Dager syndrome).
  • Parkinson’s syndrome – symptomatology of Parkinson’s disease in various neurological disorders.
  • Plexus / pudendal nerve damage
  • Polyneuropathy – chronic disorders of the peripheral nerves.
  • Spina bifida (open back)
  • Tetraplegia (paraplegia)

Pregnancy, childbirth and puerperium (O00-O99)

  • Perineal laceration III degree with injury to the sphincter (sphincter muscle).

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Anal scarring
  • Strain damage
  • Injuries such as bruising or impalement injuries.

Further

  • Anal intercourse/anal sex
  • Pelvic floor descent (“descending perineum syndrome”).
  • Radiatio (radiotherapy) in the pelvic region.
  • Zust. n. surgery in the pelvic area, especially on the continence organ; e. g. Whitehead surgery (supraanodermal hemorrhoidectomy; circular excision of the hamorrhoidal cushions; nowadays considered malpractice), hemorrhoidectomy (surgical removal of hemorrhoids), sphincterotomy (surgical severing of the sphincter), fistulotomy (fistula splitting), episiotomy (perineal incision)/birth trauma.

Medication