Fecal Incontinence

What is fecal incontinence?

Fecal, or bowel, incontinence is the inability to regulate bowel movements. It can be common among the elderly. Accidental bowel leakage is typically not an indication of something serious. However, it can affect daily life and a person’s self-confidence. Effective treatments used at the office can include:

• medication
• surgery
• minimally-invasive procedures

What causes bowel incontinence?

The most frequent cause of bowel incontinence is an injury to the muscles surrounding the anus. Vaginal childbirth and anal surgery can damage the anal sphincters, or their nerves, which can cause the condition. Other causes can include:

• Diarrhea- frequently due to an infection or irritable bowel syndrome (IBS)
• Impacted stool- due to serious constipation
• Inflammatory bowel disease- such as Crohn's disease and ulcerative colitis
• Nerve damage- this may be caused by spinal cord injury, multiple sclerosis, and diabetes
• Radiation damage to the rectum- such as that following prostate cancer treatment
• Cognitive impairment- seen following a stroke or progressed Alzheimer's disease

Multiple causes often affect the person and occasionally there may not be a clear cause.

How is bowel incontinence diagnosed?

Discussing the problem can be a little strange but it will be helpful to remember that the doctor is there to help. To make sure that the right treatments are used, the doctor may perform a physical examination of the strength of the anal sphincter. Other tests can include:

• Stool testing- stool testing can identify an infection
• Endoscopy- A tube with a camera is inserted into the anus to identify any potential issues in the anal canal or colon.
• Anorectal manometry- A pressure monitor is directed into the anus and rectum to measure the strength of the sphincter muscles.
• Endosonography- An ultrasound probe is inserted into the anus which generates images which can identify issues in the anal and rectal walls.
• Nerve tests- This can test the reaction of the nerves which control the sphincter muscles to diagnose nerve damage.
• MRI defecography- Magnetic resonance imaging can be done on the pelvis, possibly when the patient is moving the bowels on a special commode. This offers information about the muscles and supporting structures of the pelvis, anus, and rectum.