Fecal incontinence is the accidental passing of solid or liquid stool from the rectum. It is usually caused by a physical problem with a part of the body that controls the bowel.
Prevalence of Fecal Incontinence
Fecal incontinence is more common than you might think. Approximately 18 million adults in the U.S. experience this condition, with women affected more often than men. Estimates suggest that about one in 10 women have fecal incontinence. Factors that increase the risk of fecal incontinence include increasing age, pelvic floor dyssynergia, injuries to the anus and rectum caused by childbirth or surgery, chronic constipation, and poor overall health.
Diagnosing Fecal Incontinence
Fecal incontinence can be distressing but treatment is available. The biggest roadblock to treatment is not talking about fecal incontinence. It is normal to feel anxious when discussing something so private but treatments are available to those who seek help. If you suspect you may have fecal incontinence, your first step to treatment is consulting with a doctor. Health care professionals skilled in diagnosis and treatment of this disorder typically have well trained staff to put you at ease in this discussion.
If your doctor suspects you have fecal incontinence, you may need to schedule an anorectal manometry. This test uses a catheter with pressure sensors and a balloon at the tip to measure the strength and coordination of your anal sphincter and pelvic floor muscles, as well as the sensation in your rectum. A small balloon is inserted in the rectum by the nurse. Once the balloon is placed, most patients have no sensation of discomfort or pain.
This test is especially useful for revealing weak anal sphincters. Other tests commonly used to diagnose fecal incontinence include endoscopic ultrasound, which uses a device, called a transducer, to produce images that allow your doctor to examine the structure of the anal sphincter, and MRI defecography, which uses an MRI scanner to obtain images that allow your doctor to assess the function of your pelvis at various stages of defecation. The MRI may be done with some contrast placed in the rectum via an enema. It is otherwise non-invasive.
Treating Fecal Incontinence
Treatment for fecal incontinence depends on the cause as well as any symptoms you are experiencing. Three types of treatment are available for fecal incontinence: medical therapy, physical therapy, and surgery.
Medical therapy includes injectable bulking agents that help strengthen the anal sphincter to reduce or eliminate fecal leakage.
Physical therapy involves using biofeedback techniques and pelvic floor exercises to help improve the function of the pelvic floor and anal muscles.
Surgery is usually recommended only after other treatments have failed. The most common surgical procedure for fecal incontinence is sphincteroplasty, which repairs an anal sphincter torn by injury.
At Richmond Gastroenterology Associates we focus on evaluation and non-surgical management. We will refer to surgical specialists (colorectal or gynecological) when we deem appropriate.
Contact us if you would like to make an appointment with one of our physicians at Richmond Gastroenterology to discuss Fecal Incontinence.