Fecal incontinence is the loss of control over the bowels. Some people may have uncontrolled release of just gas and liquid stool. Others have no control over the release of solid waste. Many people with this condition also have trouble controlling the release of urine.
This condition can lead to issues such as depression]]> or isolation. If you think you have this condition, contact your doctor promptly.
Women are more likely to suffer from this than men. Many cases are a result of an injury to the pelvic floor. The pelvic floor is a group of muscles that support pelvic organs. Injury can happen through pregnancy or delivery]]> . Other causes include:
- Rectal prolapse
- Congenital abnormality—condition present from birth
- Trauma or injury to anal sphincter or its nerves—the healthy sphincter opens and closes to control the release of fecal material
- Scarring of the rectum from ]]>irritable bowel syndrome]]> , ]]>radiation]]> , or surgery
These factors increase your chance of fecal incontinence. Tell your doctor if you have any of these risk factors:
If you have any of these symptoms do not assume it is due to fecal incontinence. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- An inability to control bowel movements
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may send you to a specialist such as a:
- Colorectal surgeon
Tests may include the following:
- Anorectal manometry—test that uses a catheter to check pressures in the anal canal while resting and squeezing
- Pudendal nerve terminal motor latency (PNTML)—test that uses an electrode in the anal canal to evaluate how well the nerves are working
- Endoanal ultrasound—test that uses sound waves to make a picture; used to detect any injury to anal sphincter muscles
- Proctosigmoidoscopy—test that uses thin, lighted tube inside the rectum; used to examine the rectum and lower colon for injury or disease
- Defecography—test that uses x-rays and dye to look at the bowel and how it functions
Talk with your doctor about the best plan for you. Options include the following:
Your doctor may suggest changes to your diet. You may be referred to a nutritionist for diet ideas. Examples of diet changes include:
- Eating smaller meals more frequently
- Avoiding foods that trigger diarrhea (spicy food or foods with caffeine are common culprits)
You may be asked to keep track of your diet and incontinence episodes. This will help identify patterns that can be changed.
Your doctor may suggest using biofeedback]]> . This method can retrain your body’s responses. A bowel movement schedule can also train your bowels.
Surgical procedures may be used to treat this condition such as:
- An overlapping sphincteroplasty to rebuild the anal sphincter
- Injecting bulking agents, radiofrequency therapy, and/or nerve stimulation
- Inserting an artificial bowel sphincter which you can open and close as needed
- A colostomy (done in severe cases)—disconnects the colon and brings the end through an opening in the abdomen
To help reduce your chance of getting fecal incontinence, take the following steps:
- Prevent constipation with a diet high in fiber]]> and adequate fluids.
- Pay attention to your diet and avoid foods that trigger diarrhea.
- Try to maintain a regular bowel movement schedule.
- Talk to your doctor if you are having trouble with diarrhea or constipation.
International Foundation for Functional Gastrointestinal Disorders
National Digestive Diseases Information Clearinghouse
Canadian Digestive Health Foundation
Canadian Society of Intestinal Research
Fecal incontinence. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/fecalincontinence/index.htm . Accessed November 1, 2008.
Gearhart SL. Harrison's Principles of Internal Medicine . 17th edition. United States: The McGraw-Hill Companies; 2008:Chapter 291, Diverticular Disease and Common Anorectal Disorders.
Landefeld CS, Bowers BJ, Feld AD et al. National Institutes of Health State-of-the-Science Conference Statement: Prevention of Fecal and Urinary Incontinence in Adults. Ann Intern Med . 2008;148:449-458.
Last reviewed November 2008 by ]]>Daus Mahnke, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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