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Weak anal sphincter muscles can cause faecal incontinence or leakage. This can be caused by damage or injury to the muscles, heavy straining, rectal surgery, or even weight gain. The internal and external sphincter muscles wrap around the anus and control bowel movements. Weakness in these muscles can cause stool to get stuck in the anal opening, making it difficult to wipe clean. To improve bowel control, one can perform exercises to strengthen these muscles, such as squeezing the area many times a day or performing specific squeeze exercises.
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What You'll Learn
Damage or injury
Obstetrical trauma can include tears, episiotomies, or the use of a vacuum or forceps during delivery. In the case of childbirth, many women sustain tears in the perineal area, which is the region between the vaginal opening and the anus. When these tears extend to the anal sphincter, they are referred to as third- or fourth-degree tears, or obstetric anal sphincter injuries (OASIs). OASIs can cause pain, faecal and/or urinary incontinence, and sexual dysfunction.
Rectal surgery can also cause damage to the anal sphincter muscles. This may include surgeries performed to treat other conditions affecting the anal region, such as anal fissures or haemorrhoids. These conditions can be caused by changes in bowel function, such as diarrhoea or constipation, and may improve with self-care practices like eating a high-fibre diet, drinking plenty of water, and maintaining careful anal hygiene.
Additionally, injuries to the anal region can result from sexual activity. It is important to stop anal sex if there is any pain or bleeding and to refrain from further sexual activity until a doctor has been consulted. Engaging in anal sex when the skin is broken or damaged can increase the risk of HIV or sexually transmitted infections (STIs) and lead to further damage to the area.
In summary, damage or injury to the anal sphincter muscles can occur due to a variety of factors, including childbirth, rectal surgery, and sexual activity. These injuries can have both short-term and long-term physical and psychological impacts on an individual's quality of life.
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Straining or surgery
Straining during bowel movements can cause haemorrhoids, which are swollen blood vessels in the anus or rectum. This can lead to rectal prolapse, where the rectum slips down into the anal canal. Rectal prolapse can cause faecal incontinence as the anal sphincter muscles cannot close properly to prevent leakage. Straining can also be a cause of pelvic floor dysfunction, which can lead to urinary incontinence, small bowel prolapse, vaginal prolapse, and bladder prolapse.
Surgery can also be a cause of weak anal sphincter muscles. Rectal surgery can cause the rectal walls to become stiff, reducing their ability to stretch and accommodate stool, which can lead to faecal incontinence. Cancer surgery, haemorrhoid surgery, and childbirth injuries are also possible causes of injury to the sphincter muscles, which may result in faecal incontinence.
Rectal prolapse surgery, for example, carries the risk of recurrence. This is because the new rectum formed from the colon is not as strong as the original rectum. To mitigate this risk, some surgeons combine the procedure with a levatoroplasty, which involves tightening the pelvic floor muscles by sewing them closer together.
In cases of faecal incontinence caused by pelvic floor or anal sphincter muscle injuries, surgery may be an option if other treatments have failed. Physiotherapy treatments can also help improve symptoms through strengthening exercises aimed at making the external sphincter thicker and stronger. Biofeedback techniques can also be used to strengthen the external sphincter.
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Weight issues
Excessive straining during bowel movements can also weaken the anal sphincter muscles, leading to faecal incontinence or leakage. This is common in people who are overweight or obese. Additionally, weight issues can contribute to rectal prolapse during pregnancy and after childbirth. Maintaining a healthy weight can help reduce the risk of developing these issues and improving bowel control.
Being overweight or obese can put extra pressure on the pelvic floor muscles, leading to weakness over time. This can result in a loss of control over passing gas, urine leakage, and eventually, faecal incontinence. Weight issues can also increase the risk of developing haemorrhoids, which are swollen blood vessels in the anus or rectum. These conditions can cause further weakening of the anal sphincter muscles.
It is important to note that weight issues are not the only cause of weak anal muscles. Ageing, pregnancy, and childbirth, previous injuries, and certain medical conditions can also contribute to muscle weakness. However, maintaining a healthy weight through proper diet and exercise can help improve bowel control and overall quality of life.
If you are experiencing symptoms of weak anal muscles, such as leakage or difficulty controlling bowel movements, it is important to consult a healthcare professional. They can provide guidance on exercises to strengthen the pelvic floor and anal sphincter muscles, improving muscle tone and function. Physiotherapy treatments, biofeedback techniques, and targeted exercises can help individuals regain control and improve their quality of life.
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Lack of exercise
When these muscles are weak, individuals may experience leakage during exercise or when coughing or sneezing. Pelvic floor exercises, such as Kegel exercises, can help strengthen the anal sphincter and improve bowel control. Kegel exercises involve consciously tightening the pelvic floor muscles, which can be identified by stopping urine flow midstream or holding in gas.
Men and women may experience Kegel exercises differently, with men typically feeling tightness around the anus and women feeling a pull closer to the vagina. In addition to Kegel exercises, other therapies such as biofeedback and electrical stimulation can be used to strengthen the anal sphincter and improve faecal incontinence.
It is important to note that weak anal sphincter muscles can also be caused by factors other than lack of exercise, such as muscle or nerve damage from childbirth, complications from prior anorectal surgery, or advanced age. Seeking guidance from a healthcare professional can help individuals identify the underlying causes of their incontinence and determine the most appropriate treatment approach.
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Funnel-shaped anus
A funnel-shaped anus, also known as funnel anus (FA), is a rare type of anorectal malformation. It is characterised by a deep anal funnel lined with skin, a missing transitional epithelium, and stenosis secondary to a fibrotic internal sphincter. The internal and external sphincter muscles wrap around the anus, controlling bowel movements.
In a funnel-shaped anus, the weak sphincter muscle does not close properly, allowing stool to get stuck in the anal opening and causing difficulties with wiping. This can result in faecal incontinence or leakage, which can be embarrassing and impact a person's day-to-day life.
The causes of a funnel-shaped anus are not well understood, but it is believed to be a progressive condition that may eventually lead to external rectal prolapse. It is thought that chronic straining during defecation, connective tissue disorders, and anatomical factors may contribute to the development of a funnel-shaped anus. In some cases, it may be present from birth (congenital) and can be associated with other anomalies such as Currarino syndrome, hemisacrum, and tethered cord.
To improve bowel control and reduce leakage, individuals with a funnel-shaped anus can perform strengthening exercises to improve the tone and function of the sphincter muscles. These exercises involve practising squeezing the anal sphincter muscles multiple times a day, similar to the action of stopping oneself from passing wind. It is important to learn the correct technique and maintain proper form during these exercises for optimal results. Physiotherapy treatments, such as biofeedback techniques, can also be utilised to strengthen the external sphincter.
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