Fecal Incontinence: What It Is And What You Can Do About It

 

Are you leaking stool? A lot of people suffer from fecal incontinence. However, because the condition can be quite embarrassing, many of them simply refuse to report what they are going through or even seek the help of professionals. This causes the condition to get a lot worse.

Read on to find out everything you need to know about bowel incontinence and what you can do with leakage of stool.

What Is Fecal Incontinence?

 

Fecal incontinence or bowel incontinence refers to the inability of a person to control his bowel movements, resulting in stool leakage. The experience that comes with it varies from one person to another.

While some people feel the need to go to the toilet, they are unable to reach it in time. Others feel no sensation before passing stool.

The frequency can vary as well. It can happen on a daily basis on some people while others experience it from time to time.

Women are more prone to experiencing fecal incontinence as a result of childbirth. This particularly happens if the baby is too large, an episiotomy was created or if the delivery was vacuum-assisted.

The Most Common Causes of Bowel Incontinence

 

Generally speaking, fecal incontinence can happen because of an underlying medical condition or health problem. Below are some of the most common causes:

Nerve damage

 

Nerve damage can happen due to frequent straining during bowel movements, childbirth, stroke, or spinal cord injury. Conditions, like multiple sclerosis and diabetes, can also damage the nerves that sense stool in the rectal area.

Muscle damage

 

Experiencing injury to the anal sphincter or the rings of muscles at the end part of the rectum can make it hard to hold back stool properly. This commonly happens in women who gave birth, particularly those who had an episiotomy during delivery.

Diarrhea

 

Loose stool is a lot harder to keep in the rectum than solid stool. Having diarrhea can make bowel incontinence worse.

Constipation

 

Constipation, particularly the chronic type, stretches and weakens the muscles in the rectum. This allows the watery stool from the upper part of the digestive tract to seep through the impacted stool and leak out.

Rectal prolapse

 

Rectal prolapse is a condition that causes the rectum to drop down into the anus.

Reduced storage capacity of the rectum

The rectum normally stretches to accommodate the bulk of stool formed. However, after surgery or going through radiation treatment or experiencing inflammatory bowel diseases, scarring can happen. The scars lessen the ability of the rectum to stretch, causing excess stool to seep through and leak.

In addition to the list above, there are also factors that can increase your risk for fecal incontinence. This includes:

  • Being female
  • Physical disability
  • Age
  • Dementia
  • Chronic use of laxatives
  • Hemorrhoids

Diagnosing Fecal Incontinence

 

Before getting diagnosed with fecal incontinence, a physical examination will be performed. This includes the use of a probe to visually inspect the anus for any signs of nerve damage. Ideally, the probe should cause the sphincter to contract.

Apart from that, a digital rectal exam may also be performed. This is a test where the doctor inserts a gloved finger into the rectum to assess the strength of the sphincter muscles. It’s also a test to check for any other abnormalities in the area.

A balloon expulsion test, on the other hand, involves the insertion of a small balloon into the rectal area. Once inside, it’s filled with water.

The patient will be asked to pass the balloon in the toilet. Normally, it shouldn’t take him more than three minutes. Otherwise, he likely has a disorder affecting defecation.

Other tests that may need to be performed to diagnose fecal incontinence include:

  • Colonoscopy
  • Anal manometry
  • Anorectal ultrasonography
  • Magnetic Resonance Imaging
  • Protography

Treating Fecal Incontinence

 

In general, there are four ways to treat this condition. It can be a single approach or the combination of the following treatment options:

Medications

 

Anti-diarrheal drugs like loperamide hydrochloride are usually prescribed to patients experiencing fecal incontinence involving diarrhea.

For patients with chronic constipation, bulk laxatives are typically prescribed to control the condition. Psyllium and methylcellulose are two good examples.

Now, while these medications can help, it’s not ideal to take without consulting doctors. Their effectiveness in helping ease fecal incontinence will still depend on the exact cause of the condition.

Changes in Diet

 

Your food intake largely affects stool consistency. If constipation seems to be causing stool leakage, it’s ideal to drink more fluids and eat more fiber-rich foods.

In case diarrhea is making fecal incontinence worse, adding bulk to the stool can make it less watery and less likely to pass that easy.

In addition to that, keeping track of one’s diet may also help. This will help determine how one’s food intake triggers stool leakage or if there’s no connection at all.

Other Therapies

 

There are therapies that can help restore the strength of the anal sphincter. The list includes:

Bowel training- Creating a schedule when you need to use the toilet can give you greater control. It’s about making a conscious effort to go to the bathroom to have a bowel movement at a particular time of day.

Sacral Nerve Stimulation- This involves implanting a device which sends continuous electrical impulses to the nerves in the muscles of your bowl.

Vaginal balloon- With this, a pump-type device is placed into the vagina. This balloon creates pressure in the rectum, reducing the frequency of stool leakage.

 

Surgery

 

If those treatment options don’t work, surgery may be performed. To treat fecal incontinence, the following surgical options may be considered:

Sphincter replacement- An artificial anal sphincter may be used to replace a damaged anal sphincter. It’s typically an inflatable cuff which is placed in the anal region.

Colostomy- A colostomy is a surgical procedure that involves diverting stool through an opening created in the abdomen. There, a special bag is placed to collect stool.

Surgical correction of hemorrhoids, rectal prolapse, and rectocele- Correcting these conditions will likely treat fecal incontinence.

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