Fecal Incontinence

Fecal incontinence is the loss of normal control of your bowels, leading to accidental leakage of stool or gas.

Bowel control problems occur more frequently in women than men, because of injury to the anal muscles or nerves that can occur during childbirth. The condition becomes even more common with age as the muscles that control bowel movements weaken.

Fecal incontinence can be a devastating disability that leads to social isolation. While many women are embarrassed to discuss it with their doctor, treatments are available to cure or significantly improve the condition, enabling you to resume your normal lifestyle.

Symptoms may include:

• Involuntary leakage of gas
• Involuntary leakage of liquid or solid stool
• A strong or urgent need to have a bowel movement
• Stool spotting on underwear or pads
• Diarrhea
• Constipation

Symptoms may occur often or infrequently. In some cases, fecal incontinence occurs with urinary incontinence (accidental loss of urine).

Fecal incontinence occurs when there are problems with the muscles or nerves required for normal bowel function. Causes may include:

• Injury to the anal sphincter muscles or nerves, often through childbirth
• Loss of feeling in the rectum - Making it hard to tell when it is time to have a bowel movement
• Inability of the rectum to stretch and store stool
• Illnesses affecting the nervous system - Such as diabetes, multiple sclerosis or stroke
• Problems with the gastrointestinal system - Such as inflammatory bowel disease, irritable bowel syndrome, colitis or cancer of the rectum
• Surgery or radiation therapy to the pelvic area
• Certain medications
• Stools that are too loose (diarrhea) or too hard (constipation)
• Weakening of the anal sphincters due to aging
• Spinal cord damage
• Chemotherapy
• Certain sexual practices, such as anal intercourse

Diagnosis starts with a detailed medical history and thorough physical exam, including examination of your vagina, anus and rectum. You may also be asked to keep a diary to record when you have bowel movements and leakage, and other details.

Treatment depends on the cause and severity of fecal incontinence. Treatment strategies include:

• Lifestyle changes. Including changes in diet, exercise and fluid intake for more regular bowel habits
• Biofeedback training. To help strengthen and better contract the anal muscles
• Kegel exercises. To strengthen the anal muscles
• Medications or changes in current medications. To prevent diarrhea or constipation and help you have regular bowel movements
• Surgery. Including anal sphincteroplasty to repair the muscles that control bowel movements