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Fecal Incontinence*

Fecal incontinence (the involuntary loss of bowel control) affects more than 18 million Americans. Although it is a relatively common problem in older adults, it is not a normal part of aging. The inability to control your bowels can lead to embarrassment and cause you to avoid social situations, but fecal incontinence is often treatable with medication, lifestyle measures, or surgical repair of the damaged sphincter muscles. In addition, some people can benefit from an implanted device called an artificial sphincter.

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Symptoms of Fecal Incontinence

The symptoms of fecal incontinence are easily recognizable, ranging from the occasional leakage of liquid or solid stool and gas to the inability to hold a bowel movement until you reach the toilet. Other possible symptoms include diarrhea and constipation.

Causes of Fecal Incontinence

Fecal incontinence is not a disease but a symptom of another gastrointestinal problem. The most common causes are:

  • Damage to the sphincter muscles in the anus (usually due to hemorrhoid surgery or childbirth). These muscles normally contract to prevent stool from leaving the rectum.
  • Damage to nerves in the anal sphincter muscles or rectum (due to chronic constipation, stroke, diabetes, multiple sclerosis, or childbirth). Nerve damage in the sphincter muscles leads to a loss of proper functioning of the muscles, while nerve damage in the rectum leads to loss of sensation in that area, so that you no longer recognize that stool is present.
  • Loss of storage capacity in the rectum (due to rectal surgery, radiation therapy for cancer, or inflammatory bowel disease). Normally, the rectum stretches to hold stool until you reach the toilet; with loss of elasticity, an accident is much more likely.
  • Diarrhea, or loose, watery stools are much harder to control than solid stools.
  • Pelvic floor dysfunction (such as rectal prolapse, in which the rectum sags). By supporting the organs in the pelvis and lower abdomen, the muscles of the pelvic floor play a role in preventing fecal incontinence.

Diagnosis of Fecal Incontinence

Because self-treatment of fecal incontinence is rarely successful, you should see one of our providers in the Women’s Institute for Pelvic Health to understand the best treatments available for your specific condition. Our providers will do a thorough physical examination and may order one or more diagnostic tests. These tests may include:

  • Anal Manometry: to measure the tightness of the anal sphincter
  • Anorectal Ultrasonography: to examine the structure of the anal sphincter
  • Proctography / Defecography: to determine how well the rectum holds and eliminates stool
  • Proctosigmoidoscopy: to detect signs of diseases or other problems inside the rectum and sigmoid colon
  • Anal Electromyography: to test for nerve damage

*Information provided by Urology Channel.