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Anal leakage is a medical condition of faecal incontinence most recently associated with early Olestra-based products. Anal leakage affects about 2% of adults.
Causes
Diet
Foods that makes the consistency of the feces more runny such as a heavy intake of beer, can make it difficult for the anus to retain matter.
In the United States, the 'non-fat fat' called olestra (Olean) and used in some 'slimming' foods has gained unwelcome publicity for this reason. It is an artificial mixture of fats, none of which can be digested or absorbed. Instead, it goes straight along the gut and is passed out. This means that the feces are runny and slippery with fat, and anal leakage can occur. Some snack foods (e.g. some crisps) contain olestra, but the amount in the snacks is usually too small to cause a problem.
Foods which cause gas can also make leakage more likely. This is because the anus has to relax to let the gas out, and some fecal material may be propelled out at the same time.
Other Causes
Irritable bowel syndrome is the other common cause. In irritable bowel syndrome (also known as IBS), the bowel muscle squeezes strongly, so that it may be difficult to hold the feces in.
Childbirth can be a causal factor. After giving birth, more than 1 in 10 women finds that she has difficulty in controlling gas or fecal leakage. It is more with age (over 35 years of age) or from a large baby. The reason may be that the anal muscle is damaged by a tear, or by the episiotomy cut made during childbirth. Damage to the pudendal nerve can also occur during childbirth, and result in incontinence.
It is quite common to have both fecal incontinence and incontinence of urine. A study of women with incontinence of urine found that almost 1 in 4 also had some leakage of feces (Obstetrics and Gynecology 2002;100:719–23). The connection is that both are related to childbirth, especially if the baby was large.
Aging is a factor as well. Faecal leakage is also quite common in the older people, because the anal muscle becomes weaker with age. This is something that you should definitely discuss with your doctor, because a lot can be done to help. The real reason may be constipation – if one has hard feces in the lower bowel, some watery feces can leak round them and be difficult to control. Doctors are very familiar with this problem (called ‘overflow incontinence’).
Though a controversial matter, anal leakage may also become occurrent in people who engage in frequent anal sex. Due to the continual stretching of muscular fibres and the straining of the muscles the anal sphincter becomes weakened. The effect is often avoided, see oral sex.
Medications
Some medications make the feces looser and therefore more difficult to hold in. A laxative or drugs as an indigestion remedy that contains magnesium trisilicate can cause diarrhea. Misoprostol (a medication for stomach and duodenal ulcers that is sometimes prescribed for elderly people) is another possible cause.
Orlistat (Xenical) is a diet pill that works by blocking the enzymes that digest fat. This means that the fat cannot be absorbed from the gut. With the correct dose, a third of the fat that you eat is blocked, and is excreted in the faeces instead of ending up as part of visceral fat. By the time it reaches the lower part of the gut, this extra fat has the consistency of light machine oil. As a result, it can cause oily anal leakage, and the problem gets worse the more fat you eat. To stop it happening, you have to eat less than 70 g of fat a day.
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