WHAT IS FECAL INCONTINENCE?

Fecal (or bowel) incontinence is the impaired ability to control gas, liquid, or solid stool. It ranges from mild (difficulty to control passage of gas) to severe (leakage of formed stool). Fecal incontinence is a very common problem (33-50% of people over 65 years old) and is rarely discussed due to embarrassment.

WHAT CAUSES FECAL INCONTINENCE?

  •   Obstetric injuries.
  •   Trauma to anal sphincter muscles.
  •   Diminished muscle strength due to age.

There are many causes of fecal incontinence. Most common is childbirth. These injuries are caused by normal deliveries with muscle stretching or tearing as well as nerve injury. Some injuries may be recognized immediately while others may appear 20-30 years later.

Anal operations or traumatic injuries can damage the anal sphincter muscles and nerves that control continence. These injuries may result in fecal incontinence in younger people.

Colon infections may cause diarrhea and bleeding that may lead to fecal incontinence. Seek a professional evaluation.

HOW IS FECAL INCONTINENCE DIAGNOSED?

The first part of the diagnosis is a discussion with a colon & rectal surgeon about your symptoms and medical/surgical history. A diet and medication history is very important.

Your lifestyle (active, retired, working, sedentary etc.) and goals are also discussed.

A physical exam of the anal area is done.

If needed, several tests may be used. These tests are painless and do not require a bowel prep. Anal-rectal manometry (testing of the anal sphincter muscles and reflexes) as well as nerve testing. This is a 30 minute outpatient test.

Ultrasound, CAT scans, MRI, and colonoscopy may be needed.

WHAT CAN BE DONE TO CORRECT THE PROBLEM?

Treatments include:

Dietary changes

Constipating medications

Muscle strengthening exercises

Biofeedback

Surgical anal sphincter repair

Sacral Stimulation

Artificial sphincter placement

WHICH TREATMENT IS RIGHT FOR ME?

Everyone is different, however for mild incontinence, dietary changes and constipating medications usually work. For moderate incontinence muscle strengthening exercises and biofeedback is helpful. For severe fecal incontinence surgery may be the best option.