What is Fecal Incontinence?
An inability to control bowel movements is commonly known as fecal incontinence or bowel incontinence. This medical condition can cause uncontrolled leakage of stool. While fecal incontinence can happen to anyone, it is most commonly seen amongst women and older adults.
The cause of fecal incontinence will vary between all patients; however, the following are common causes and medical conditions that could cause anal leakage:
- Muscle and/or nerve damage: possible causes of this damage include old age, childbirth, spinal cord injuries, consistent straining during bowel movements, stroke or having an episiotomy.
- Diabetes
- Multiple sclerosis
- Surgery around the anus or rectum
- Certain medications
- Hemorrhoids: these prevent the anus from closing which could lead to stool leakage.
- Late-stage dementia
Symptoms of Fecal Incontinence
Fecal incontinence symptoms will vary from patient-to-patient due to the severity of the disease. Some of the most common symptoms that may be experienced include:
- Accidental leakage of gas or stool
- Losing control of bowel movements
- Chronic diarrhea or constipation
Additional symptoms that are completely normal to experience with bowel incontinence are depression and anxiety, embarrassment, skin irritation and social isolation. If you’re experiencing any of the listed symptoms, speak with your provider to find the best solution for you.
Diagnosing Fecal Incontinence
Fecal incontinence is diagnosed through a combination of medical history, physical examination, and sometimes additional tests. Here's how it typically works:
- Medical History: Your healthcare provider will ask you questions about your symptoms, including when they started, how often they occur, and whether you have any other medical conditions or have had any surgeries that might be related.
- Physical Examination: A physical examination may involve checking the strength of your anal sphincter muscles and looking for any signs of damage or abnormalities in the rectum or anus.
- Anorectal Manometry: This test measures the strength of the muscles in the anus and rectum. It involves inserting a small, flexible tube into the rectum and asking you to squeeze and relax your muscles while the pressure is measured.
- Endoscopy or Proctosigmoidoscopy: In some cases, a flexible tube with a camera on the end (endoscope) or a metal tube with light source (proctoscope) may be used to examine the inside of the rectum and anus for any abnormalities or signs of damage.
- Imaging Tests: Imaging tests such as ultrasound, MRI, or CT scan may be done to look for structural problems or abnormalities in the pelvic area.
- Stool Testing: Stool samples may be collected and tested for signs of infection or other conditions that could be causing or contributing to fecal incontinence.
Based on the results of these tests, your healthcare provider can determine the underlying cause of your fecal incontinence and develop an appropriate treatment plan.
Treatment of Fecal Incontinence
Symptom severity will vary between patients – the treatment option will also vary. Treatment options may include lifestyle changes, exercises, therapy, medications, or surgery. Some of the treatment options may include but are not limited to:
- Consistent exercise
- Pelvic floor exercises (like Kegels): working with a Pelvic Floor Physical Therapist.
- Bulking agent injections: thickening the anus walls.
- Surgery to fix existing rectal or anal issues such as hemorrhoids or rectal prolapse.
- Sacral Nerve Stimulator: an implanted device that stimulate nerves to increase anorectal muscle tone and improve symptoms
- Colostomy surgery: diverting feces away from the rectum and anus to an opening in the abdomen. Bag is attached to the abdomen opening to catch all feces.