Fecal Incontinence/
Accidental Bowel Leakage (ABL)
Fecal Incontinence/Accidental Bowel Leakage (ABL)
Fecal incontinence or accidental bowel leakage (ABL) - the impaired ability to control gas or stool - can range in severity from mild difficulty with gas control to severe loss of control over liquid or formed stools on a daily basis. It is not an uncommon condition and it often coexists with urinary problems, but unfortunately, due to embarrassment, many sufferers of fecal incontinence do not seek treatment.
What causes fecal incontinence/ABL?
There are numerous causes, the most common being injury during childbirth, which may help explain the higher prevalence of fecal incontinence in women. These childbirth injuries are usually due to a separation of the muscles (sphincters) that control continence. Injury of the nerves controlling these muscles may also contribute to the problem.
Previous anal surgery is another potential cause of fecal incontinence - however, injury to these muscles may not become evident immediately. This is because the muscles controlling bowel function tend to weaken with age and incontinence may not become an issue until later in life.
Other risk factors include:
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Irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), Crohn's disease, ulcerative colitis and other digestive disorders, such as chronic constipation and chronic diarrhea (especially after gallbladder removal)
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Diabetes
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Obesity
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Stroke
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Neurologic conditions
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Dementia
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Multiple sclerosis
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Radiation to the pelvic floor from cancer treatment
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Surgery in the pelvis (such as prostate, cervical, uterine and colorectal cancer)
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Trauma due to either an accident or a vaginal birth
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Scleroderma
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Damage to the central nervous system and spinal cord
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Rectal prolapse
Several methods of assessment and forms of treatment are available. Collaboration among medical and surgical specialists is an integral part of our multi-disciplinary approach to complex pelvic floor disorders. When dealing with such problems as urinary incontinence and other disorders, a combined approach is often necessary prior to undertaking proper treatment.
How is the cause determined?
Initially, discussion with your physician will determine the severity of the problem. An appointment can then be made with a colon and rectal surgeon, which will entail a complete physical exam and an account of your history with the problem.
Further testing can include:
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Anorectal manometry: Measures resting and squeeze pressures throughout the length of the anal canal
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Pudendal nerve testing: A procedure in which an electrode is used to locate the nerve and sense sphincter contraction. Anorectal manometry and pudendal nerve testing assess the degree of muscle weakness and determine whether injury to the nerves is also contributing to your condition.
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Ultrasound: If muscle injury is a possibility, an ultrasound that allows visualization of internal and external sphincter muscles will also be performed to assess for a defect.
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Defecography: If no defect is found, a special x-ray called defecography may then be necessary to investigate other potential causes of incontinence.
How is fecal incontinence/ABL treated?
Mild problems may be addressed with dietary changes or constipating medications. Strengthening the pelvic floor through Kegel squeezes can also improve symptoms.
Physicians who specialize in the treatment of ABL may also prescribe disposable rectal inserts or a long-term vaginal insert called the Eclipse system. They may also offer an office-based procedure to bulk the anal canal, or an outpatient surgery to place a pacemaker for the pelvic floor called sacral neuromodulation, or Interstim. More invasive surgical options may be offered if these treatments do not resolve symptoms.
If a separation in the muscle is found during assessment of a patient, surgery to repair these muscles may be considered. Sphincteroplasty is the surgical procedure that repairs the defect in the muscles that control continence. It involves "overlapping" the normal muscle to repair the defect, hopefully resulting in improved bowel control.
Fathima hospital, backed by specialists from multiple disciplines, specialises in handling high risk pregnancies. It is important to note that women, who are diagnosed with high-risk issues, mostly go on to have a normal pregnancy and a healthy delivery.
Fathima hospital offers pain relief programs that are globally applied to ease pain during labour. There are a number of options to ensure painless delivery, many of which pregnant women here are not aware of.
Fetal medicine focuses on the care of pregnant women where there is a need to monitor the health and wellbeing of the unborn child (fetus). This includes monitoring the rate of the baby’s growth, as well as diagnosing and managing fetal disorders and abnormalities using both invasive and non-invasive methods.
Our specialized fertility experts are highly experienced, and their technology and strict processes ensure high success rates. IVF (In-Vitro Fertilization) is a type of assisted reproductive technology which involves a series of procedures to treat fertility and assist with the conception of child.
Fathima Hospital has customized Antenatal programmes designed to make you feel safe, good and happy, these programmes educate you on the process of childbirth and the different stages of labour - in all, encouraging natural birthing as much as possible.
Postnatal exercises are important for you. They help you regain the strength of your abdominal muscles and help prevent lower back injury and other complications like abdominal organs from "drooping forward" due to lack of support. They also help you regain a flat stomach.
Our OB/GYN surgeons offer a variety of traditional and minimally invasive surgical procedures: Tubal ligation, removal of ovarian cysts, fibroids, growths from the cervix, Removal of the uterus (hysterectomy), ovaries, Hysteroscopy etc.
Fetal medicine, which is an extension of the branch of Ultrasonography, treats the fetus as a patient in utero for any problems it might have. It comprises of Fetal scanning, Procedures such as Amniocentesis, chorionic villus sampling, and cord blood sampling, Screening tests and interpretation of the results.
When it comes to your little one’s health, you need to be extra sure. Hence, you want to know all the whys and when of vaccinations to be administered to your child from the time of birth. Keeping that in mind, we hand you over a vaccination schedule for your baby with all the mandatory and optional vaccines prescribed from the time of birth.
Pregnancy Care
Each pregnancy is unique and you have the right to be involved in all decisions affecting you and your baby. A good relationship with your maternity care provider can make a big difference in planning your pregnancy care. At Fathima hospital, Department of Obstetrics includes a team of expert gynaecologists, foetal medicine Specialist, physiotherapists, and trained and experienced nursing staff. Our hospital is equipped with advanced neonatal care team supported by state-of-the-art NICU infrastructure to ensure that complex and high-risk pregnancies can be managed including extremely premature birthings.
Pregnancy Trimesters
At Fathima Hospital, we provide comprehensive consultations, lab testing, ultrasound scan to provide the best possible care during your 1st Trimister to 3rd Trimister. A typical pregnancy lasts 40 weeks from the first day of your last menstrual period (LMP) to the birth of the baby. It is divided into three stages, called trimesters: first trimester, second trimester, and third trimester. The fetus undergoes many changes throughout maturation. A woman will experience many changes during the pregnancy like morning sickness, or nausea and vomiting due to pregnancy, at 6–8 weeks. A pregnant woman might also feel very tired and notice that she is more emotional than usual due to hormonal changes.
Types of Delivery
Few things in life are more exciting than the birth of a new baby. This has been the case throughout human history, but childbirth options for new mothers have advanced to make the experience more safe. Fathima hospital offers comfortable maternity suites that convert into state of the art delivery rooms. An easy birth and a perfectly executed birth plan is ideal. But we know that even the most carefully planned birth can take twists and turns. In those cases, it's important to be prepared for alternative delivery methods.
Pregnancy Scans
A range of tests is available if you are pregnant. These tests can confirm your pregnancy and also monitor your baby’s development in the womb. Regular check-ups with your gynecologist, fetal medicine specislists are an important part of pregnancy care, including information and advice about what tests you and your baby will need. Checking the general health of the mother and baby, the different kinds of tests available to pregnant women include: tests to confirm pregnancy, maternal health screening, routine screening tests (these tell you how likely it is that your baby has a certain health condition), diagnostic tests – for pregnancies at increased risk (these tell you more accurately if your baby has a certain health condition).
Pregnancy Complications
Complications can arise in pregnancies for many reasons. Sometimes a woman’s existing health conditions contribute to problems. Other times, new conditions arise because of hormonal and body changes that occur during pregnancy. They can involve the mother’s health, the baby’s health, or both. Some women have health problems that arise during pregnancy, and other women have health problems before they become pregnant that could lead to complications. It is very important for women to receive health care before and during pregnancy to decrease the risk of pregnancy complications. If you are receiving treatment for a health problem, your health care provider might want to change the way your health problem is managed.
High Risk Pregnancy
A high-risk pregnancy is one that threatens the health or life of the mother or her fetus. It often requires specialized care from specially trained providers. Some pregnancies become high risk as they progress, while some women are at increased risk for complications even before they get pregnant for a variety of reasons. Early and regular prenatal care helps many women have healthy pregnancies and deliveries without complications. A high-risk pregnancy may be one that involves chronic health problems, such as diabetes or high blood pressure; infections; complications from a previous pregnancy; or other issues that might arise during pregnancy. Treatment for high-risk pregnancy depends on the risk factors and overall health of the mother and fetus.
Vaccination
Ideally, women of child bearing age should be immunized before becoming pregnant to protect their babies against various diseases. Pregnancy should not deter a woman from receiving vaccines that are safe and will protect both her health and that of her unborn child. Extreme care has to be taken to avoid those vaccines that harm the unborn baby. Pregnant women who aren’t up-to-date on their immunizations may be susceptible to diseases that can harm them or their unborn child. If you’re pregnant, talk to your doctor about which vaccines you may need and whether you should get them now or wait until after your child is born.
Bad Obstetric History
Pregnancy loss is a frustrating and challenging problem for couples and clinicians alike. Miscarriage is often associated with guilt, embarrassment and depressive states. This is particularly true when the patient presents with subsequent pregnancy with added concerns of primary or secondary infertility, irregular menses, absent or irregular ovulation, a known history of uterine fibroids, a family history of miscarriage, advancing age, medical history and a prior history of pregnancy complications. It certainly warrants a detailed consultation and reassurance with a practitioner committed to pregnancy loss evaluation.
Ectopic / Tubal Pregnancy
Pregnancy begins with a fertilized egg. Normally, the fertilized egg attaches to the lining of the uterus. An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. An ectopic pregnancy most often occurs in a fallopian tube, which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Sometimes, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina. An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.
Multiple Pregnancy
A multiple pregnancy occurs when one egg (ovum) splits before implanting or when separate eggs are each fertilized by a different sperm. Identical twins or triplets occur with the fertilization of a single egg that later divides into two or three identical embryos. Identical twins or triplets have the same genetic identity, are always the same sex, and look almost exactly the same. Fraternal multiples develop from separate eggs that are each fertilized by a different sperm. Fraternal twins might or might not be of the same sex and might not necessarily resemble each other any more than two siblings from the same parents might.
Pregnancy Care
Your pregnancy is one of the most exciting times of your life. At Fathima hospital, we will help you enjoy the journey with the support of our expert team, in modern private surroundings.
Families have trusted us for generations at this special time, and we have an enviable international reputation for private maternity care.
Our expertise enables us to safely look after you and your baby, whether it is your first child, your third child, you are expecting twins, or if you or your little one has additional health needs. Whatever your situation, we have the right team to support you. Our packages have been devised with you in mind, to give you the time and attention you need to make the birth of your child as special as possible.
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Fathima hopsital - Maternity care facilities Process Chart
The best practices to ensure the that a mother gets utmost care during pregnancy and labor. Here is a list of our resources enabling to help you prepare for everything, from conception to delivery and beyond. Fathima hospital is fully equipped to comply with the maternity care Process chart.
Treatments and Procedures
The Department of Obstetrics & Gynaecology has the capability and facilities to deal with a diverse range of cases and complexities in partnership with specialty services such as Foetal Medicine, Anaesthesia, Critical care, high risk, painless labour, Gynaecological surgeries for fibroid, prolapsed, endometriosis, ovarian cysts, Laparoscopic and hysteroscopic surgeries
