Management of Fecal Incontinence for the Advanced Practice Nurse by Donna Z. Bliss

Author:Donna Z. Bliss
Language: eng
Format: epub, pdf
ISBN: 9783319907048
Publisher: Springer International Publishing

8.4 Risk Factors for Fecal Incontinence in Nursing Home Patients

8.4.1 Age

Age has been confirmed as a risk factor for fecal incontinence in many population-based studies [2]. Normal anorectal physiologic function is complex and relies on several different functions, including anatomic and neurologic factors. A review by Norton et al. found the results from physiological studies on the aging bowel to vary due to (a) a variety of different techniques used in measuring anorectal function, (b) unclear definition of the normative range of manometric measures for older people, (c) poor matching between cases and controls of clinical factors which may affect gut function (e.g., level of mobility) or inadequate clinical information, and (d) usually small subject numbers. However, studies on healthy older adults report that anorectal function is characterized by a tendency toward an age-related reduction in internal anal sphincter tone (basal pressure) after the age of 70 years in both genders, but to a greater degree in women. There also seems to be a decline in external anal sphincter tone (squeeze pressure) in women after the age of 70 years and in men after the age of 90 years. There seems to be an age-related increase in anorectal sensitivity thresholds and a reduced rectal compliance. However, rectal motility seems to be well preserved [8]. Overall, the physiological data suggest that fecal incontinence should not be considered an inevitable consequence of aging alone [2]. Colonic function in general, and fecal incontinence specifically, appears to be more influenced by factors associated with aging than with aging itself [2].

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