From the Guidelines
Fecal matter adheres to the intestinal mucosa primarily due to a lack of enteric propulsion, which can be caused by various factors including adhesions, hernias, neoplasms, and certain medical conditions such as adynamic ileus and colonic pseudo-obstruction. The intestinal mucosa is normally protected by a layer of mucus that prevents stool from sticking to it. However, when this layer is disrupted or when there is a lack of movement in the intestines, stool can adhere to the mucosa. According to 1, adynamic ileus and colonic pseudo-obstruction are caused by a lack of enteric propulsion, which can be due to drugs, trauma, postoperative period, metabolic disturbance, and other different basis.
Some of the key factors that contribute to fecal matter adhering to the intestinal mucosa include:
- Insufficient dietary fiber
- Inadequate hydration
- Certain medical conditions such as inflammatory bowel disease, irritable bowel syndrome, or diverticulosis
- Adhesions, hernias, and neoplasms that can cause mechanical obstruction
- Adynamic ileus and colonic pseudo-obstruction that can cause a lack of enteric propulsion
To address this issue, it is essential to identify and treat the underlying cause. Increasing daily fiber intake to 25-30 grams through fruits, vegetables, and whole grains, and drinking at least 8 glasses of water daily can help. Over-the-counter fiber supplements like psyllium husk (Metamucil) at 1 teaspoon 1-3 times daily mixed with water can also help. If constipation is present, a gentle osmotic laxative like MiraLAX (polyethylene glycol) at 17g daily can soften stool. As noted in 1, a computed tomography scan with intravenous contrast may be necessary to confirm the diagnosis and guide treatment.
In terms of treatment, a conservative approach should be initiated with nasogastric suction and fluid replacement therapy, and a scrupulous wait-and-see strategy should be adopted. After gastric contents are cleared, a water-soluble contrast administration challenge should be performed. If the patient has adhesive small bowel obstruction with ischemia or perforation, then surgery should be performed as soon as possible, with a laparoscopic approach attempted if possible.
From the Research
Causes of Fecal Matter Adherence to Intestinal Mucosa
- The exact cause of fecal matter adhering to the intestinal mucosa is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest that intestinal inflammation, which can be caused by various factors such as genetic predisposition, immune dysregulation, and environmental factors, can lead to changes in the intestinal mucosa and potentially affect the adherence of fecal matter 3, 4.
- Inflammatory bowel disease (IBD), which includes conditions such as Crohn's disease and ulcerative colitis, can cause symptoms such as diarrhea, abdominal pain, and rectal bleeding, and may also lead to changes in the intestinal mucosa 3, 4, 5.
- The studies also mention that dysregulation of mucosal immunity and the overproduction of inflammatory cytokines can contribute to intestinal inflammation and potentially affect the intestinal mucosa 3, 4.
- Additionally, the use of certain substances such as polyphenols, which have anti-inflammatory properties, may help to regulate intestinal inflammation and potentially reduce the adherence of fecal matter to the intestinal mucosa 6.
Related Factors
- Intestinal inflammation can be caused by a combination of genetic, immune, and environmental factors 3, 4.
- The activation of pattern recognition receptors, such as Toll-like receptors and nucleotide-binding oligomerization domain proteins, in epithelial cells can trigger intestinal inflammation 6.
- The differentiation of regulatory T cells by activating a transcription factor Foxp-3 can suppress intestinal inflammation 6.
- Polyphenols and other phytochemicals can modulate the receptors and signaling molecules involved in intestinal inflammation, and may have anti-inflammatory effects 6.