Effect of Autoimmunity in Fecal Incompetence

Fecal incontinence is an embarrassing social problem to the patients affecting patients’ work and social ordinary life. It affects both sexes characterized by inability to control bowel motions causing leaking stool or flatus unexpectedly from the rectum and anus, and in severe cases, it causes a complete loss of bowel control. The causes are severe diarrhea, constipation, muscle and nerve damage that is caused by aging, vaginal delivery, episiotomy or forceps delivery. Anal and rectal continence depends on many aspects like consistency of stool, neuromuscular sphincter complex, rectal capacity, sensation of defecation and ability to move and reach a toilet. Another cause is immunological disorders that cause muscle damage due to formation of autoantibodies in autoimmune diseases or in association with gastrointestinal manifestation of autoimmune diseases like multiple scleroses and other autoimmune diseases. Simply, it can be diagnosed by routine digital rectal examination that has good sensitivity and poor specificity in discriminating small from severe anal sphincter defects.