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Fecal Incontinence
What is fecal incontinence?
Fecal incontinence is difficulty in controlling bowel function. Loss of control of gas, liquids and solid bowel movements all fall under this definition.
What are the risk factors for fecal incontinence?
Risk factors include: obstetric trauma (vaginal deliveries, episiotomies and tears during delivery), other rectal trauma, neurological conditions (such as stroke, diabetes or muscular dystrophy) and prior rectal surgery. Conditions that cause diarrhea, including inflammatory bowel disease, can also be associated with poor fecal control.
What causes fecal incontinence?
The most common cause of fecal incontinence is injury to the anal sphincter muscle resulting from childbirth. Other injuries to the anal sphincter mechanism secondary to anal trauma or surgery (i.e., hemorrhoid surgery), or poor nerve function can also cause fecal incontinence.
How is fecal incontinence diagnosed?
The symptoms of fecal incontinence are themselves good evidence of the condition. A thorough examination by a physician often includes a history and physical, as well as pelvic floor studies, including manometry, pudendal nerve latency testing, ultrasound, EMG and defacography.
What treatments are available?
Multiple treatments are available, including dietary modification, medications to bulk stools/antidarrheals, and biofeedback. If these initial treatments fail, surgical intervention can be very useful in some candidates. Surgical options include overlapping sphincteroplasty, articificial bowel sphincter, sacral nerve stimulation and other innovative techniques.
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