What is Fecal Incontinence
Fecal incontinence, also called accidental bowel leakage, is not being able to control your bowels.
This condition happens because the nerves or muscles around the anus do not work the way they should. This affects their ability to hold stool.
What are the causes?
This condition may be caused by:
- Damage to the muscles at the end of the rectum (sphincter).
- Damage to the nerves that control bowel movements.
- Diarrhea.
- Chronic constipation.
- Pelvic floor dysfunction. This means the muscles in the pelvis do not work well.
- Loss of bowel storage capacity.
What increases the risk?
This condition is more likely to develop in people who:
- Are born with bowels or a pelvis that has not formed correctly.
- Have had rectal surgery.
- Have had radiation treatment for certain cancers.
- Have irritable bowel syndrome (IBS).
- Have an inflammatory bowel disease (IBD), such as Crohn disease.
- Have been pregnant, had a vaginal delivery, or had surgery that damaged the pelvic floor muscles.
- Have a complicated childbirth, spinal cord injury, or other trauma that causes nerve damage.
- Have a condition that can affect nerve function, such as diabetes, Parkinson disease, or multiple sclerosis.
- Have a condition where the rectum drops down into the anus or vagina (prolapse).
- Are older.
What are the signs or symptoms?
The main symptom of this condition is not being able to control your bowels. You also might not be able get to the bathroom before a bowel movement.
How is this diagnosed?
This condition is diagnosed with a medical history and physical exam. You may also have tests, including:
- Blood tests.
- Urine tests.
- A rectal exam.
- Ultrasound.
- MRI.
- Colonoscopy. This is an exam that looks at your large intestine (colon).
- Anal manometry. This is a test that measures the strength of the anal sphincter.
- Anal electromyogram (EMG). This is a test that uses small electrodes to check for nerve damage.
How is this treated?
Treatment varies depending on the cause and severity of your condition. Treatment may also focus on addressing any underlying causes of this condition. Treatment may include:
- Medicines.
This may include medicines to:
- Prevent diarrhea.
- Help with constipation (laxatives).
- Treat any underlying conditions.
- Physical therapy.
- Fiber supplements. These can help manage your bowel movements.
- Nerve stimulation.
- Injectable gel to promote tissue growth and better muscle control.
- Surgery.
You may need:
- Sphincter repair surgery.
- Diversion surgery. This procedure lets feces pass out of your body through a hole in your abdomen.
Follow these instructions at home:
Diet
- Follow instructions from your health care provider about any eating or drinking restrictions. Work with a dietitian to come up with a healthy diet and to help you avoid the foods that can make your condition worse. Keep a diet diary to find out which foods or drinks could be making your fecal incontinence worse.
- Drink enough fluid to keep your urine clear or pale yellow.
Lifestyle
- If you smoke, talk to your health care provider about quitting. This may help your condition.
- If you are overweight, talk to your health care provider about how to safely lose weight. This may help your condition.
- Increase your physical activity as told by your health care provider. This may help your condition. Always talk to your health care provider before starting a new exercise program.
- Carry a change of clothes and supplies to clean up quickly if you have an episode of fetal incontinence.
- Consider joining a fecal incontinence support group. You can find a support group online or in your local community.
General instructions
- Take over-the-counter and prescription medicines only as told by your health care provider. This includes any supplements.
- Apply a moisture barrier, such as petroleum jelly, to your rectum. This protects the skin from irritation caused by ongoing leaking or diarrhea.
- Tell your health care provider if you are upset or depressed about your condition.
Where to find more information
American Academy of Family Physicians: www.aafp.org
International Foundation for Functional Gastrointestinal Disorders: www.iffgd.org
Contact a health care provider if:
- You have a fever.
- You have redness, swelling, or pain around your rectum.
- Your pain is getting worse or you lose feeling in your rectal area.
- You have blood in your stool.
- You feel sad or hopeless.
- You avoid social or work situations.
Get help right away if:
- You stop having bowel movements.
- You cannot eat or drink without vomiting.
- You have rectal bleeding that does not stop.
- You have severe pain that is getting worse.
- You
have symptoms of dehydration, including:
- Sleepiness or fatigue.
- Producing little or no urine, tears, or sweat.
- Dizziness.
- Dry mouth.
- Unusual irritability.
- Headache.
- Inability to think clearly.
