Only a doctor can tell you for sure since Pilonidals take different courses in different people. Some people may just experience a bit of a pain when sitting, others may only have some drainage and no pain, still others will be making a trip to the ER or surgeon because they are in excruciating pain. The usual signs of an acute infection are swelling and pain in the tailbone region. Most people end up at this site by Googling "tailbone pain". The most singular common symptom is discomfort in the area around the tailbone.
Even the doctors don’t agree on this issue but we can give you the primary prevailing opinion: Without getting too technical, the primary theory on Pilonidal Disease involves "follicular occlusion" which is the blocking and inflammation of pores in the midline of the buttocks. This tends to occur in the tailbone area because of the friction and pressure on the area that stretches the pores when the person is sitting. We caution people to make sure your doctor has the latest info on Pilonidal Disease. There are an appalling number of "old school" doctors out there who still think that Pilonidal is completely congenital and there is no way to get rid of it. You can usually spot these doctors by their use of the phrase "the cure is worse than the disease.
Somewhat. There are plenty of instances where multiple family members have Pilonidal Disease. Doctors speculate that this is due to the inherited shape of the buttocks and natal cleft, type of hair and predisposition to blocked follicles/pores.
Causes can include: * Muscle damage. Injury to the rings of muscle at the end of the rectum (anal sphincter) may make it difficult to hold stool back properly. This kind of damage can occur during childbirth, especially if you have an episiotomy or forceps are used during delivery.
* Nerve damage. Injury to the nerves that sense stool in the rectum or those that control the anal sphincter can lead to fecal incontinence. The nerve damage can be caused by childbirth, constant straining during bowel movements, spinal cord injury or stroke. Some diseases, such as diabetes and multiple sclerosis, also can affect these nerves and cause damage that leads to fecal incontinence.
* Constipation. Chronic constipation may cause a dry, hard mass of stool (impacted stool) to form in the rectum and become too large to pass. The muscles of the rectum and intestines stretch and eventually weaken, allowing watery stool from farther up the digestive tract to move around the impacted stool and leak out. Chronic constipation may also cause nerve damage that leads to fecal incontinence.
* Diarrhea. Solid stool is easier to retain in the rectum than is loose stool, so the loose stools of diarrhea can cause or worsen fecal incontinence.
* Hemorrhoids. When the veins in your rectum swell, causing hemorrhoids, this keeps your anus from closing completely, which can allow stool to leak out.
* Loss of storage capacity in the rectum. Normally, the rectum stretches to accommodate stool. If your rectum is scarred or your rectal walls have stiffened from surgery, radiation treatment or inflammatory bowel disease, the rectum can’t stretch as much as it needs to, and excess stool can leak out.
* Surgery. Surgery to treat enlarged veins in the rectum or anus (hemorrhoids), as well as more-complex operations involving the rectum and anus, can cause muscle and nerve damage that leads to fecal incontinence.
* Rectal prolapse. Fecal incontinence can be a result of this condition, in which the rectum drops down into the anus.
* Rectocele. In women, fecal incontinence can occur if the rectum protrudes through the vagina.
4) What are the Risk factors? A number of factors may increase your risk of developing fecal incontinence, including:
* Age. Although fecal incontinence can occur at any age, it’s more common in adults over 65.
* Being female. Fecal incontinence can be a complication of childbirth. Recent research has also found that women who take menopausal hormone replacement therapy are more likely to have fecal incontinence.
* Nerve damage. People who have long-standing diabetes or multiple sclerosis — conditions that can damage nerves that help control defecation — may be at risk of fecal incontinence.
* Dementia. Fecal incontinence is often present in late-stage Alzheimer’s disease and dementia.
* Physical disability. Being physically disabled may make it difficult to reach a toilet in time. An injury that caused a physical disability also may cause rectal nerve damage, leading to fecal incontinence.
5) Complications Complications of fecal incontinence may include:
* Emotional distress. The loss of dignity associated with losing control over one’s bodily functions can lead to embarrassment, shame, frustration and depression. It’s common for people with fecal incontinence to try to hide the problem or to avoid social engagements.
* Skin irritation. The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to pain and itching, and potentially to sores (ulcers) that require medical treatment.
* Reduce constipation. Increase your exercise, eat more high-fiber foods and drink plenty of fluids.
* Control diarrhea. Treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid fecal incontinence.
* Avoid straining. Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence.
Bowel movements should be soft and formed. They should pass easily like toothpaste flowing out of a tube.
The standard time frame for normal bowel movement (BM) frequency ranges
from as many as three bowel movements per day to as few as three bowel
movements per week. This is a wide range. Our program usually gives patients
suffering from constipation a rescue drug to use if no bowel movement has
occurred in 3 days’ time. The colon draws water from stool, the longer stool sits
in the colon, the harder the stool becomes. What is more important is whether
you are comfortable with your bowel movement frequency or whether there has
been a significant change from your typical bowel movement frequency.
Body position can help you to move your bowels. While sitting on the toilet,
placing your feet on a small step stool can position the rectum at an angle which
makes it easier to pass stool. Bowels like a routine, so eating the same amounts
around the same time of day helps to regulate the bowels. Bowels also like
regular exercise to keep them moving. Eat a fiber rich diet (refer to our high fiber
diet teaching sheet on the web site). Plenty of decaffeinated fluid (if you are not
on fluid restrictions) also helps to keep bowel movements soft.
Most Americans eat only 12 grams of fiber a day. The recommended amount is
between 25-35 grams of fiber a day. To find out how much fiber you are eating,
read the nutrition label of your foods and add the grams of fiber together. When
you add fiber to your diet, you will initially be gassy. This gas will decrease over
time. For this reason we recommend adding only 5-6 grams of fiber to your diet
every two weeks.
No there is no difference whether you eat fiber or take a supplement. Some
patients feel that the supplement makes them have less gas.
There are different types of constipation. Not all types of constipation are best
treated with additional dietary fiber. For instance, our program has found that
people with dysynergic defecation or slow transit constipation may experience
worsening symptoms with increased dietary fiber.
Activia can improve mild constipation. Studies have shown an initial improvement
in 2 weeks. Most patients eat 2 Activia a day to receive the best benefit.
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