Fecal incontinence - bowel incontinence
Fortunately, effective treatments are available for fecal incontinence. Your primary care physician may be able to assist you, or you may need to see a doctor who specializes in treating conditions that affect the colon, rectum and anus, such as a gastroenterologist, proctologist or colorectal surgeon. Treatment for fecal incontinence is usually able to help restore bowel control or at least substantially reduce the severity of the condition.
Treatment depends on the cause of your incontinence and may include changes to your diet, medication, exercises to help you regain control of your bowels, surgery or a combination of treatments.
For example, if chronic constipation is to blame for fecal incontinence, your doctor may recommend that you drink plenty of fluids (about 8 to 10 glasses of water, preferably, daily) and eat fiber-rich foods that aren't constipating. If diarrhea is contributing to the problem, your doctor may recommend that you increase your intake of high-fiber foods to add bulk to your stools, making them less watery. In general, your doctor will recommend a diet that helps you gain good stool consistency for increased control of your bowels.
Sometimes, doctors recommend medications to treat fecal incontinence, such as:
If fecal incontinence is due to a lack of anal sphincter control or decreased awareness of the urge to defecate, you may benefit from a bowel retraining program and exercise therapies aimed at helping you restore muscle strength.
In some cases, bowel retraining means learning to go to the toilet at a specific time of day. For example, your doctor may recommend that you make a conscious effort to have a bowel movement after every meal. This helps you gain greater control by establishing with some predictability when you need to use the toilet. This technique can work well for children who have constipation and fecal incontinence because they forget to use the toilet. Children can learn to use the toilet at scheduled times.
In other cases, bowel retraining involves an exercise therapy called biofeedback to help you strengthen and coordinate the muscles involved in holding in stool.
Biofeedback involves inserting a pressure-sensitive probe into your anal canal. This probe registers muscle strength and activity of your anal sphincter as it contracts around the probe. You can practice sphincter contractions and learn to strengthen your own muscles by viewing the scale's readout as a visual aid. A typical program comprises two visits to your doctor's office, for 3 to 4 days. Sometimes, one session is all you need.
Treatment for stool impaction
Your doctor may have to remove an impacted stool if taking laxatives or using enemas don't help you pass the hardened mass. To remove an impacted stool, a doctor inserts one or two fingers into the rectum and breaks the impacted stool into fragments that you can later expel.
Surgical options for fecal incontinence
For some people, treatment of fecal incontinence requires surgery to correct an underlying problem. Surgical options include:
Sacral nerve stimulation
Another treatment for fecal incontinence is sacral nerve stimulation.
The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Direct electrical stimulation of these nerves is a promising treatment option for fecal incontinence caused by nerve damage.
Sacral nerve stimulation is carried out in stages. First, four to six small needles are positioned in the muscles of your lower bowel, and these muscles are stimulated by an external pulse generator. The muscle response to the stimulation generally isn't uncomfortable.
Following a successful response, a temporary stimulation wire is introduced into the stimulation needle and fixed to the skin. The results of stimulation are then recorded over a period of 10 to 21 days. If your incontinence is improved for up to 14 days, you may have a pulse generator permanently implanted.
The permanent pulse generator is implanted in your abdomen. A wire from the small, battery-driven device is connected to the sacral nerves. Through the wire, the device generates electrical impulses that stimulate the nerves, helping you regain continence.
Can fecal incontinence be prevented? It depends on the cause of the problem.
Fecal incontinence due to chronic constipation can be improved or eliminated by treating the constipation. Getting more exercise, eating high-fiber foods and drinking plenty of fluids are generally advised to avoid constipation.
If diarrhea is to blame, treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid accidents.
Straining during bowel movements eventually may weaken anal sphincter muscles and, at times, lead to fecal incontinence, so avoid straining when possible.