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Fecal Incontinence

What is Fecal Incontinence

Fecal (or bowel) incontinence is the inability to control bowel movements. There has been damage to the muscles (sphincters) or their nerves surrounding the anus. Fecal incontinence is a lack of control over defecation, leading to involuntary loss of bowel contents – including flatus, liquid stool elements and mucus, or solid feces. FI is a sign or a symptom, not a diagnosis. FI can result from different causes and might occur with either constipation or diarrhea.

Causes of Fecal Incontinence

  • Child birth
  • Anal surgery
  • Impacted stool (severe constipation), often in older patients
  • Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
  • Nerve damage (diabetes, spinal cord injury, multiple sclerosis, or other conditions)
  • Radiation damage to the rectum (prostate cancer)
  • Cognitive impairment (from a stroke or Alzheimer’s)
  • Anal intercourse

Diagnosis of Fecal Incontinence

  • Examination by your physician
  • Stool testing
  • Endoscopy - a tube with a camera and a light that is inserted into the anus. You are sedated and will feel no discomfort.
  • Anorectal manometry – a pressure monitor that is inserted into the rectum to measure the strength of the sphincter muscles.
  • Endosonography – an ultrasound probe that is inserted into the anus which produces images that help identify issues in the anal and rectal walls.
  • Nerve tests – to measure the responsiveness to the nerves controlling the sphincter muscles.

Treatment of Fecal Incontinence

  • Diet – eating 20 to 30 grams of fiber daily. This makes the stool more bulky and easier to control.
  • Avoid caffeine
  • Drinking plenty of water. This avoids dehydration and constipation
  • Medications – Imodium, Lomotil, Hyoscaymine, Viberzi
  • Exercise – pelvic exercises – Kegel
  • Bowel training – create a routine of timely bowel movements
  • Surgery