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Fecal Incontinence
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Fecal incontinence

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DIGESTIVE SYSTEM
Diseases & Conditions  

Fecal incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Also called bowel incontinence, fecal incontinence can range from an occasional leakage of stool while passing gas to a complete loss of bowel control.

When to seek medical advice

See your doctor if you develop fecal incontinence or if your child develops fecal incontinence. Often, new mothers are reluctant to tell their doctor about their problems with fecal incontinence after childbirth. But repairing a torn anal sphincter muscle soon after delivery can prevent long-term complications.

A number of tests are available to help diagnose what's causing the problem and determine the right treatment.

Screening and diagnosis

To determine the cause of fecal incontinence, your doctor will ask you questions related to your condition — such as when and how often you experience an inability to control your bowels.

In addition to talking with you, your doctor may also perform a physical examination. The exam usually includes a visual inspection of your anus and the area lying between your anus and genitals (perineum) for hemorrhoids, infections and other conditions. Your doctor may use a pin or probe to examine this area of skin. Normally this touching causes your anal sphincter to contract and the anus to pucker. This test helps your doctor check for nerve damage.

Your doctor may perform a digital exam. This involves him or her inserting a lubricated finger into your rectum to evaluate the strength of your sphincter muscles and to check for any abnormalities of the rectal area. During the exam, your doctor may ask you to bear down. Bearing down helps him or her check whether rectal prolapse or certain other conditions exist.

A number of medical tests also are available to help pinpoint the cause of fecal incontinence. These may include:

  • Anorectal manometry. In this commonly used test, your doctor inserts a narrow, flexible tube into your anus and rectum. Once the tube is in place, a small balloon at the tip of the tube may be expanded. This test is used to check the tightness of your anal sphincter and its ability to respond to nerve firings, as well as the sensitivity and function of your rectum.

  • Anorectal ultrasonography. In this procedure, your doctor inserts a narrow, wand-like instrument into your anus and rectum. This instrument, which is attached to a computer and video screen, emits sound waves. The waves bounce off the walls of your rectum and anus, producing video images of these internal structures. Ultrasonography helps your doctor evaluate the structure of your anal sphincter muscles.

  • Proctography. In this procedure, your doctor inserts into your rectum a small amount of a liquid called barium, which coats the walls of your rectum. This coating makes your rectum more visible on X-rays that are then taken. Also known as defecography, this procedure shows how much and how well your rectum may hold stool, and how well your rectum may evacuate stool.

  • Proctosigmoidoscopy. In this test, your doctor uses a long, slender tube attached to a video camera and monitor to examine your rectum and sigmoid — approximately the last 2 feet of your colon. This procedure allows your doctor to look inside your rectum for signs of disease or other problems that could cause fecal incontinence.

  • Anal electromyography. This test involves the insertion of tiny needle electrodes into muscles around your anus. These tests reveal any signs of nerve damage.

Complications

Loss of bowel control may cause embarrassment and shame. It's not uncommon for someone who has fecal incontinence to try to hide the problem from others and withdraw socially. The loss of dignity associated with losing control over one's bodily functions can lead to frustration, anger and depression.

Beyond the emotional aspects of the condition, fecal incontinence can also cause skin irritation. The skin around the anus is delicate and sensitive. Repeat contact between skin and stool can lead to pain, itching and, potentially, sores (ulcers) that require medical treatment.

Fecal incontinence > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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