Fecal Incontinence

What is Fecal Incontinence?
Fecal Incontinence is the involuntary loss of feces. This can significantly impair quality of life.

Risk Factors and Causes
Risk factors, and factors that contribute to, or cause fecal incontinence include increased age, dementia, depression, neurologic disease, spinal cord injury, anal trauma, surgery on the anal sphincter, impaired mobility, history of multiple pregnancies, history of giving birth to a high-birthweight infant, obstetrical sphincter injury, type 2 diabetes, loose stools, radiation proctitis, inflammation of the colon, and fecal impaction. Females are also more likely to suffer from incontinence than males.

Symptoms
People with fecal incontinence may have sudden, urgent need to defecate with inability to control it. Others may have leakage of stool without ever feeling the urge to have a bowel movement. Some people have complete loss of stools. Others have smaller amounts of leakage periodically.

Evaluation
Dr. Ahmed will perform colonoscopy to assess for underlying causes of the fecal incontinence or diarrhea. Sometimes bloodwork and imaging tests are used as well. In some patients, anorectal manometry or endorectal ultrasound are used to diagnose sphincter weakness or abnormalities.

Treatment
If GI evaluation reveals an underlying cause for the incontinence or diarrhea, treating this is the first step. Patients with fecal incontinence should avoid foods or activities that they feel increase fecal incontinence episodes or diarrhea, and should consider keeping a food and symptom diary. For some patients this may include artificial sweeteners, caffeine.

Barrier creams and skin hygiene can help prevent against perianal irritation or infection. In patients with physical or mental impairment, developing a defecation program can be helpful. Bulking agents such as fiber can improve incontinence in some patients. Anti-diarrhea medications can be helpful as well.

Kegal exercises are broadly recommended for patients with fecal incontinence. In refractory cases, biofeedback therapy can be helpful to retrain muscles.

Dr. Ahmed offers some procedures for fecal incontinence, which can dramatically improve symptoms. One of these is Solesta, which is an injectable anal bulking agent. The other is Interstim, which is a sacral nerve stimulator. Both of these can tremendously improve symptoms and quality of life in patients with fecal incontinence.

If you suffer from fecal incontinence, please contact Dr. Ahmed today. You do not have to live with fecal incontinence forever.