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Facing Fecal Incontinence

Fecal incontinence, also known as loss of bowel control, is a common problem, affecting one in 12 adults in the U.S. The condition aggravates with age, but it is not a normal part of aging. It can involve complete loss of control over the bowels or occasional leakage, such as when coughing or passing gas. Treatment options are available.

Causes of fecal incontinence include, but are not limited to:

  • Chronic constipation and/or diarrhea
  • Muscle damage, such as may occur with childbirth or surgeries
  • Dysfunction in or damage to the nervous system as a whole from injury or conditions like multiple sclerosis, Parkinson's disease, Alzheimer's disease, brain tumor or stroke
  • Severe depression
  • Irritable Bowel Syndrome
  • Rectal prolapse
  • Medications

Diagnosis

Diagnosis begins with a physical exam, often followed by one of more of these common diagnostic tests:

  • Sigmoidoscopy or colonoscopy – a visual inspection of the intestinal tract, using a thin lighted tube inserted through the anus, to look for tumors, scar tissue or inflammation
  • Manometry – uses a balloon at the tip of a narrow flexible tube inserted into the anus and rectum and expanded to measure rectal sensitivity and sphincter muscle strength
  • Electromyography (EMG) – uses tiny needle electrodes to test nerve function in pelvic floor and rectal muscles
  • Defecography (also known as proctography) – uses X-rays to evaluate the process of stool elimination
  • Ultrasound – uses a narrow tube inserted into the anus and rectum that emits sound waves to produce video images
  • Magnetic Resonance Imaging (MRI) – uses radio waves and magnets to produce images of the rectal region, including the anal sphincter muscles 

Treatment Options

There are a number of treatment options for fecal incontinence:

  • Conservative options – include establishing regular bowel habits, medications, dietary changes, and pelvic muscle (Kegel) exercises, as well as the use of suppositories and enemas
  • Biofeedback – to assist with Kegel exercises or with relaxation and stretching of the pelvic floor
  • Injectable Bulking Agents – involves injecting non-absorbable materials around the anus to bulk the muscle and improve sensation
  • Anorectal Balloon Training
  • External Electrical Stimulation
  • Sacral Nerve Stimulation (InterStim) – A pacemaker-like device is used to control the nerves related to the bowels and rectum. This device is also used for urinary incontinence.
  • SECCA Procedure – involves delivering radiofrequency energy to the anal canal to thicken the tissue and improve sphincter muscle function
  • Surgery– various options are available for treatment of rectal muscles:
    • Surgery for rectal prolapse, rectorcele or hemorrhoids
    • Rectal sphincter repair – involves correcting defects in the rectal muscles to tighten and strengthen the sphincter
    • Artificial Anal Sphincter – implanting an inflatable synthetic sphincter that is controlled by the patient with a pump placed discretely inside the body
    • ACE Procedure – a one-way path is created into the colon to enable the patient to insert a small tube to flush out the colon on a regular basis
    • Colostomy – a surgically created opening in the abdominal wall through which stool is eliminated into an attached collection bag

The MidMichigan Difference

  • MidMichigan facilities are conveniently located in safe and friendly communities, with easy access and parking. 

Your Next Steps

For more information about fecal incontinence, talk to your physician. For a physician referral, visit our Find a Doctor section, or call the MidMichigan Health Line at (989) 839-9090 or toll-free at (800) 999-3199.