Fecal Incontinence

Overview and Facts about Fecal Incontinence

Fecal incontinence, also referred to as bowel incontinence, is the inability to control bowel movements. This leads to leaking stool (feces) from the rectum without warning.

The severity of the condition can range from occasional leakage that happens while passing gas to a complete loss of bowel control. Some people may not recognize when they need to defecate, which is called passive incontinence.

Symptoms and Signs of Fecal Incontinence

In the majority of circumstances, people who experience fecal incontinence only do so when they have diarrhea. In other cases, people have chronic fecal incontinence in which they are unable to resist the urge to defecate. Urge incontinence comes on so suddenly that people cannot make it to the toilet on time.

Digestive health and bowel problems associated with fecal incontinence include:

• Diarrhea
• Constipation
• Gas and bloating

Causes and Risk Factors of Fecal Incontinence

For many people with fecal incontinence, more than one cause is at play. These causes can include:

• Muscle damage in the rectum
• Damage in the nerves that sense when there is stool in the rectum
• Chronic constipation that ultimately strains the muscles in the sphincter or causes nerve damage
• Diarrhea
• Lowered storage capacity in the rectum
• Hemorrhoid surgery, which can cause muscle or nerve damage
• Rectal prolapse, which can happen if the rectum drops down into the anus
• Rectocele, which is when the rectum protrudes through the vagina

Tests and Diagnosis of Fecal Incontinence

Tests used to diagnose fecal incontinence usually involve a discussion about symptoms combined with a physical exam of the anus to see how the muscles and nerves are functioning. The specific medical tests include:

• Digital rectal exam to evaluate the strength of the muscles
• Balloon expulsion test, which involves inserting a small, water-filled balloon in the rectum and trying to expel it
• Anal manometry, which utilizes a narrow, flexible tube to help measure the tightness of the rectum and anus
• Anorectal ultrasonography, which is when a narrow instrument is inserted into the anus and rectum to produce pictures for the doctor to evaluate the anal structure
• Proctography, which is an X-ray taken while having a bowel movement
• Proctosigmoidoscopy, which is when a flexible tube is inserted into the rectum to inspect the last two feet of the colon for signs f inflammation, tumors or scar tissue that could be causing fecal incontinence
• Colonoscopy to inspect the whole colon
• Magnetic resonance imaging (MRI), which provides the doctor with full imagery of the sphincter to evaluate the strength of the muscles

Treatment and Care for Fecal Incontinence

There are a number of different treatment options for fecal incontinence. Medications such as antidiarrheal drugs, bulk laxatives, and injectable bulking agents may be appropriate.

Your doctor may also recommend dietary changes, certain exercises like Kegels, therapy, and a skin care regimen to keep the skin around the anus clean to avoid irritation.