Similar to urinary incontinence when you cannot control when your bladder voids, fecal incontinence refers to the inability to hold in a bowel movement. Fecal incontinence can be mild or severe—it can be so much as a “leak” while passing gas, or there may be full fecal incontinence, where a patient cannot hold in their bowel movements at all. Fecal incontinence isn’t often serious and there are few complications, but it can be very embarrassing to a patient. Fecal incontinence treatment can help with quality of life, and treating fecal incontinence is important for patients to begin to live normal lives again.
Fecal (anal) incontinence is the medical term for when bowel movements can’t be controlled. In other words, a patient has some kind of leak from the anus and rectum, whether it’s mild or severe. Women are much more likely to experience fecal incontinence than men, and it is more common in older people. Here are some examples of what bowel leakage may look like:
Fecal incontinence may present with other symptoms, such as diarrhea, which can cause discomfort.
The primary symptom of fecal incontinence is the inability to hold in stool, which should be noticeable in most patients. Fecal incontinence can be accompanied by other disorders, such as:
If you’re experiencing these symptoms along with an inability to hold in stool, you should contact your gastroenterologist for fecal incontinence treatment.
There are several causes of fecal incontinence. Most of them are related to changes in how the body functions, particularly muscle and nerve damage. Some of the more common causes of fecal incontinence are:
Many patients don’t consult primary care or their gastroenterologist because of embarrassment over fecal incontinence. However, there are many fecal incontinence treatment options, and your physician needs to assess you properly for the proper diagnosis or to rule out any causes. You should speak to a doctor if fecal incontinence persists or if it is accompanied by other symptoms. Some diagnostic tests your physician may run include:
Fecal incontinence treatment is often managed with dietary changes and bowel training (also known as biofeedback), but medications or surgery may also be used.
Your doctor may recommend that you avoid any foods that cause loose stool, such as caffeine, alcohol, prunes, fruit juice, spicy foods, and dairy products. Things that can help thicken stool include applesauce, peanut butter, bananas, pasta, and potatoes. Your physician may also recommend a fiber supplement.
Bowel training is typically done in two stages: you’ll take an enema at consistent times throughout the day to help your bowel movements become more consistent. Secondly, your gastroenterologist may recommend exercising certain muscles, such as Kegel exercises. A therapist trained in pelvic floor therapy can help with the second half of bowel training.
Your doctor will make specific suggestions for medications, and some may be over-the-counter. Do not take any over-the-counter supplements or medications first without consulting your physician. Some treatments may include loperamide imodium for diarrhea and other treatments as directed by your doctor. They may also suggest creams (such as diaper cream) to help ease the irritation around the anal areas.
Surgery is only used in the most severe cases to treat fecal incontinence. Several options include:
