Fecal Incontinence

Definition

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 right away.

Causes

Women are more likely to suffer from this condition than men are. 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:

• Constipation
• 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)
• Diarrhea
• Scarring of the rectum from irritable bowel syndrome, radiation therapy, or surgery
• Anal abscess or perirectal abscess

Rectal Prolapse

The rectum falls through the anal opening.

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Risk Factors

Risk factors include:

• Gender: female
• History of episiotomy
• Older age
• Diseases of the nervous system (eg, stroke)
• Damage to the spinal cord (eg, cauda equina syndrome)
• Other risk factors thought to contribute to fecal incontinence include:
  • Diabetes
  • Depression
  • Lack of physical activity
  • Being overweight

Symptoms

The main symptom is the inability to control bowel movements, which leads to stool leakage.

Diagnosis

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:

• Gastroenterologist
• Colorectal surgeon
• Proctologist

Tests may include the following:

• Anorectal manometry—test that uses a catheter to check pressure in the anal canal while resting and squeezing
• Pudendal nerve terminal motor latency (PNTML) testing—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 a 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

Treatment

Talk with your doctor about the best plan for you. Options include:

Prevention

To help reduce your chance of getting fecal incontinence, take the following steps:

• Prevent constipation by eating a high-fiber diet and drinking plenty of 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.