13 November 2017

Take 30: Faecal incontinence

Clinical Gastro

Patients that spend time texting, completing crosswords and reading a book on the toilet may suffer from faecal incontinence, says Dr John Lumley, a colorectal surgeon and the director of colorectal diagnostics.

Faecal incontinence is defined by social context; it is the inability to defer defaecation to the appropriate time and place.

This definition is subjective and therefore makes the epidemiology difficult, says Dr Lumley.

Knowing what is normal helps, he says. It’s normal to have bowel motions three per day to three per week.

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“We should spend less than two minutes on the toilet,” says Dr Lumley. “So, there’s no crossword, there’s no reading a book, there’s no texting. You get on, you get going, you get off.”

It’s normal to have an internal sphincter muscle resting tone of at least 50mmhg.

“And when we get the sensation that we want to go to the toilet, we should be able to squeeze to hold on and our squeeze pressure – and that’s related to our external sphincter muscle, the voluntary muscle – should be 65 mmhg,” he says.

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