Conditions

Fecal Incontinence

What is fecal incontinence?

Fecal incontinence or anal incontinence is the involuntary loss of liquid or solid stool. This can occur during times of rest or exercise. This may be slight smearing of feces to complete loss of bowel function. Almost 1 in 10 people suffer from incontinence, and, of the nearly 20 million people in the United States with this condition, only half will seek medical attention.

There are many conditions that lead to fecal incontinence, but the end effect is always a reduction in quality of life. Additionally, this condition leads to significant embarrassment, depression and isolation. This is not a problem unique with aging, but is certainly more common in older patients. Many patients feel they have to “just live with i,t” but there are very effective treatments available.

How is fecal incontinence diagnosed?

After taking a careful history and performing a physical exam, we work with the patients to correct any underlying or contributing factors such as ongoing diarrhea. Testing for this includes evaluation for metabolic, hormonal and electrolyte abnormalities. Certain imaging studies including pelvic ultrasound and MRI defecography can be indicated. Colonoscopy and/or sigmoidoscopy may help us define structural problems. A test of pelvic floor muscle innervation and function, known as anorectal manometry, is an important test when evaluating fecal incontinence.

How is fecal incontinence treated?

We start with conservative approaches such as dietary changes. Strengthening the anal sphincter using Kegel exercises or specialized pelvic floor physical therapy may be beneficial. Medications aimed at the underlying problem can help such as bulking fiber for fecal smearing or anti-diarrhea agents for loose or liquid stools. If after one to three months there is no significant improvement, we consider advanced therapies.

The next stage of treatment involves placement of a device known as an InterStim. This is a device that utilizes nerve stimulation to help cure or reduce fecal incontinence. This device is a highly effective and clinically proven therapy that has been available for many years, and it offers up to 90 percent success in improving bowel control. Many patients truly have a return to normal life and activities as a result of undergoing this therapy. We have expertise in fecal incontinence and treatments like the InterStim device, and encourage you to schedule a consultation if you or a loved one suffer from this condition.