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