Fecal incontinence is the involuntary loss of fecal matter or gas. It is often called the “silent affliction” because people are too embarrassed to discuss the problem with a doctor. Leaks can be distressing because they are unpredictable, difficult to hide and the associated odor can ruin social situations.
Fecal incontinence is more common than most people realize, with up to 11 percent of people experiencing it. It is one of the most common reasons people are placed in nursing homes.
What causes fecal incontinence?
The causes of fecal incontinence include change in the consistency of stool, damage to the nerves or muscles in the pelvis and other anatomical problems.
Controlling the bowels becomes more difficult as the consistency of bowel movements loosens. Gas is harder to control than loose stool, and loose stool is harder to control than solid, formed stool.
Normal bowel control requires you to sense that stool is arriving in the rectum and anus. The nerves and muscles that control the rectum, anus and pelvic floor must be intact for this to occur. If they are damaged, this can lead to incontinence.
Protrusions into the anus also can cause the condition. This includes hemorrhoids and rectal prolapse, which is when part of the rectum falls out of place and sometimes sticks out of the anus.
What are the symptoms of fecal incontinence?
- Unintentionally losing fecal matter or gas when coughing, laughing or participating in other activities.
- Feeling a strong urge to have a bowel movement or release gas and being unable to hold it.
- Finding fecal stains or fecal matter on underwear even though you did not feel stool escaping.
- Shunning social events and canceling participation in favorite activities because of leaks or fear of leaks.
- Avoiding wearing a bathing suit or light-colored clothing because of leaks or fear of leaks.
How is fecal incontinence diagnosed?
Our team will review your family medical history, perform a physical exam and run tests. Sometimes, radiological studies are necessary.
How is fecal incontinence treated?
There are many options for treating fecal incontinence, and often a combination of therapies is used. Options include:
- Doing nothing. Some patients decide their problem is not severe enough to require treatment.
- Medication. Medications are available to treat the different causes of incontinence. Our staff will help determine which medication best suits your needs.
- Strengthening the pelvic floor muscles and anal sphincter. We can teach patients exercises to strengthen the muscles that control the release of bowel movements. This approach can correct mild symptoms and significantly improve severe fecal incontinence. Learning the correct techniques can help maximize results.
- Managing behavior. What you eat and drink can affect bowel control. Eliminating or reducing artificial sweeteners and lactose can help. Having the right balance of fluid and fiber also is important for stool consistency.
- Surgery. Many surgical options are available, including correcting hemorrhoids and repairing torn sphincter muscles.
- Stimulating the bowel nerve. This is accomplished with the placement of an implant that is similar to a pacemaker. The procedure, called sacral neuromodulation, involves putting a generator in the buttocks and connecting it to a wire resting near the sacral nerve that comes from the bladder. The generator sends electrical impulses that slow down the signals causing frequent urination. This outpatient procedure is an appealing option for patients whose condition has not improved using conventional treatments.
Christiana Care Center for Urogynecology and Pelvic Surgery
Medical Arts Pavilion 2
4735 Ogletown-Stanton Road, Suite 1208, Newark, DE 19713 directions
Christiana Care Concord Health Center
161 Wilmington-West Chester Pike, Chadds Ford, PA 19317 directions
610-361-1030, option 9
Smyrna Health & Wellness Center
100 S. Main Street, Suite 215
Smyrna, DE 19977 directions
501 West 14th Street
Gateway Building, 2nd Floor
Wilmington, DE 19801