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Incontinence (Bowel/Fecal)
- When bowel movements cannot be controlled
- Stool (feces/waste) leaks out of the rectum at unwanted times with/without awareness
- Happens more often in women than in men, and often amongst older people
- Frequent diarrhea/constipation
- Muscle damage
- Older age
- Nerve damage
- Inability of the rectum to stretch
- Reduced rectal storage capacity
- Rectal prolapse (rectum falls into the anus) or rectocele (rectum pushes into the vagina)
- Chronic constipation
- Laxative abuse
- Radiation treatments
- Certain nervous system/congenital defects
- Inflammatory bowel disease
- The feeling of needing to go and not being able to make it to the bathroom in time
- Stool leaks out when passing gas
- Stool leaks out due to physical activity/daily life exertions
- Stool is seen in the underwear after a normal bowel movement
- Complete loss of bowel control
- Physical exam, including rectal exam
- Anal Manometry: A short, thin tube is inserted up into the anus and rectum to measure sphincter tightness
- Studies the strength of the anal sphincter muscles
- Endoluminal (anal) Ultrasound: A small probe is inserted up into the anus and rectum to take images of the sphincters
- Helps evaluate the shape and structure of the anal sphincter muscles and surrounding tissue
- Pudendal Nerve Terminal Motor Latency Test: Measures the functions of the pudendal nerves, which are involved in bowel control
- Anal Electromyography (EMG): Determines if nerve damage is the cause and examines the coordination between the rectum and anal muscles
- Flexible Sigmoidoscopy/Proctosigmoidoscopy: Sigmoidoscope is inserted into the rectum so the bowel can be viewed
- Evaluates the end of the large bowel/colon, looking for any abnormalities
- Proctography/Defecography: A small amount of liquid barium is released through a tube into the colon and rectum
- An x-ray video is taken that shows how the rectum is functioning
- Magnetic Resonance Imaging (MRI): To evaluate the pelvic organ
- Dietary Changes: Eliminate foods that can cause loose stools from your diet ie: beans, cabbage family vegetables, dairy products, dried fruit, spicy foods, artificial sweeteners
- Bowel Retraining (Biofeedback): Developing a “going-to-the-bathroom” pattern to gain greater control over bowel movements
- Have a trained therapist teach you certain exercises to increase anal muscle strength
- Oral Medication: Anti-diarrheal drugs and bulk laxatives to decrease movement of the stool through the intestine and firm it up
- Surgery
- Sphincteroplasty
- Repairs a damaged or weakened anal sphincter that occurred during childbirth
- Doctors identify an injured area of muscle and free its edges from the surrounding tissue
- They then bring the muscle edges back together and sew them in an overlapping fashion, strengthening the muscle and tightening the sphincter
- Rectocele or rectal prolapsecorrection
- Can be done surgically to reduce or eliminate fecal incontinence
- Sphincter replacement
- A damaged anal sphincter can be replaced with an artificial anal sphincter
- The device is essentially an inflatable cuff, which is implanted around your anal canal
- When inflated, the device keeps your anal sphincter shut tight until you’re ready to defecate
- To go to the toilet, you use a small external pump to deflate the device and allow stool to be released
- The device then reinflates itself
- Sphincter repair (Dynamic Graciloplasty)
- Muscle from the inner thigh is taken and wrapped around the sphincter, restoring muscle tone to the sphincter
- Sacral nerve stimulation
- A small device (a neurotransmitter) is implanted under the skin in the upper buttock area
- The device sends mild electrical impulses through a lead that is positioned close to a nerve located in the lower back (the sacral nerve), which influences the bladder, the sphincter and the pelvic floor muscles
- Colostomy (Bowel Diversion)
- Stool is diverted through an opening in the abdomen and a special bag is attached to this opening to collect the stool
- A last resort treatment
- Sphincteroplasty
