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Continence and incontinence

Continence and incontinence



Continence and incontinence—urgency

How is control maintained?

We can all relate an episode of food poisoning leading to Diarrhoea and the total loss of control over the normal functioning of the musculature that maintains continence.
The whole episode can be most embarrassing and humiliating as it can happen at any time and anywhere.
Thankfully, this is rare for most people but can be a nightmare for those who suffer repeated episodes due to a physiological problem.

The loss of control of one’s bowels is called ANAL INCONTINENCE and can be caused by many factors and there is often interplay of more than one factor leading to this problem. 
1. The formation and Consistency of the STOOL is very important. A perfectly formed stool will exit the bowel effortlessly in the expected way.
2.The frequency of bowel movements is determined by many factors-how often we eat, what we eat.
3.The mass movements or Peristaltic waves that move the contents of the intestines towards the anal exit are created by contractions of the muscles that make up the wall of the intestines. Weakness in these muscles can be expected to influence the strength and force of these mass waves.
The “Locks” or “valves” that make up the SPHINCTERS in the gastrointestinal tract control the entry of content from one segment into the next.
These Sphincters are also made of muscles which may receive nerve impulses from the autonomic nervous system and the contraction and relaxation of these muscles may be either under voluntary or involuntary control.
The strength of the Sphincter muscles will determine how well the “locks” or “valves” function. A weak Sphincter muscle may not be able to function well and may allow leakage of content in either direction from one segment to the next. A weak Anal Sphincter is often the main problem in cases of incontinence.
5.The efficiency of complete Rectal emptying can also play a part.
Complete emptying is in turn accomplished only if the stool is well formed, the musculature of the Sigmoid Colon and Rectum is working efficiently and the correct posture for evacuation of the Bowels is adopted to create an open passage for stool to pass effortlessly.
Damage to the Pelvic floor muscles can take place during Childbirth in women, during surgery and due to repeated straining while trying to open the bowels. Weakening of these muscles can contribute to the problem of anal incontinence but is not usually the primary cause.

If one is not able to consciously contract the external anal sphincter with sufficient strength in order to keep the anal canal closed when faeces arrive into the anal canal from the rectum, this can lead to URGENCY and incontinence.

Malfunctioning of musculature of the ANAL SPHINCTERS can be a cause of this problem. This can result from damage to the anal sphincter muscle due to infection, difficult child birth, and anal surgery or repeated
rectal prolapse.
Nerve damage due to a difficult vaginal delivery can also cause malfunction of the anal sphincter mechanism.

However, more often than not the problem reverts back to what type of foods we eat and how often we eat them.
The mass movements created in the sigmoid colon and rectum creates pressures that propel the contents towards the anal exit.
The strength of this pressure needs to be matched or balanced by the pressures created by the ANAL SPHINCTERS. Faeces can only pass out of the anal canal when the pressures above the anal canal are greater than those below.
When the force of a bowel motion that is delivered to the rectum is higher than that created by the anal sphincters, it is impossible to “hold” on anymore.
Anyone who has suffered from “explosive” diarrhoea will know this fact only too well.
This indicates that it is the CONSISTENCY of the faecal matter or stool and the force or speed at which it is propelled into the rectum that determines the urgency of evacuation.

The force of propulsion of faecal matter is determined by the contractions of the muscles of the large intestine. Therefore all the factors that may affect these waves of contractions will affect urgency—

Eating and drinking,
Exercise and movement,
the act of getting out of bed in the morning,
anxiety and stress

These can all contribute to reflex contraction of the muscles of the large intestines and the resultant mass waves that propel content downward towards the rectum and anus.
Eating foods containing agents which may contribute to the normal propulsive contractions may aggravate the situation. Spicy food is known to do this.

The consistency of the stool is determined by dietary factors and often intolerance to certain types of foods that may further aggravate an existing problem.
Intolerance to Gluten and Lactose are examples. Inclusion of the correct balance of fibre in the diet rather than excluding various possible causes is often the correct approach to cure the problem of urgency and faecal incontinency.

The correct balance of SOLUBLE and INSOLUBLE fibre in the diet will help produce the PERFECTLY FORMED STOOL. This SOLID, FIRM, SOFT, BULKY and SLIMY or SLIPPERY stool will allow control to be exerted over its exit.

Stool that has the soft and pasty consistency of porridge will fail to initiate the reflex contractions of the rectum when necessary and will not be expelled completely.
Our bowels were designed to handle the evacuation of a SOLID stool the shape of a BANANA or SAUSAGE. The SOLID and BULKY stool is able to stimulate the stretch receptors in the rectal wall by distention or stretching and cause the reflex contractions which propel the stool nearer to the anal exit.

Once the evacuation of this solid stool has been initiated by adopting the correct posture and relaxing the external anal sphincter by conscious thought, the force of GRAVITY and MOMENTUM created by the BULK and weight of the stool will maintain the gentle rectal contraction waves to expel the stool in its entirety, without flaking or breaking up. This will leave the rectum empty and anything at all to wipe!


How to heal and prevent Bowel disorders

Diet is not about what you should NOT eat, it’s about what you should include in the diet that matters.
As long as your diet includes the correct balance of plant foods containing soluble fibre, insoluble fibre and resistant starch your colon will produce the perfectly formed stool. The important next step is to evacuate this stool without straining so that the body does not suffer from the pressures created each time the bowel is emptied.

In order to heal and prevent bowel disorders you need to make lifestyle changes that last the rest of your life time.

1. Include more fluids and plant food containing soluble fibre, insoluble fibre and resistant starch in the diet so that the perfectly formed stool will be made in the colon and beneficial bacteria will flourish and eliminate disease causing bacteria and fungi.

2. Evacuate the perfectly formed stool by adopting the squat posture to eliminate the need to strain during bowel movements.

It is not possible or safe to squat on the modern raised toilet seat installed in all western homes and it is impossible to squat for any length of time if you have not done this from childhood onwards. This makes the use of any raised platforms impossible to adapt to.

The SquattLooStool is designed to allow you to adopt the squat posture while seated comfortably on your raised toilet seat.
The single best and easiest lifestyle change you will ever make, leading to a healthier body.