Fecal Incontinence (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
In this Article
- Bowel incontinence (fecal incontinence) definition
- What causes bowel incontinence?
- What are the symptoms of bowel incontinence?
- How is bowel incontinence diagnosed?
- What is the treatment for bowel incontinence?
- What about bowel incontinence in children?
- Can bowel incontinence be prevented?
- What is the prognosis for bowel incontinence?
- Find a local Gastroenterologist in your town
What are the symptoms of bowel incontinence?
Bowel incontinence refers to the inability to control the passage of small amount of stool, liquid or solid, or control flatus.
People are sometimes reluctant to discuss their lack of bowel control because of the social stigma attached to it. Their initial complaint might be anal itching (pruritis ani), a buttock skin infection, or breakdown of the skin and ulcers.
How is bowel incontinence diagnosed?
Taking a history is very important and the health care professional will spend time learning about how often loss of bowel control occurs, in what situations and whether it is solid, liquid, or gas. Past medical and surgical history is important, especially obstetric history or surgery of the anus, including hemorrhoids. It could be several years before the complication of a surgery or childbirth lead to fecal incontinence. Dietary habits and medications (including over-the-counter medications and laxative) will also be considered and evaluated.
Physical examination will likely include a rectal examination to assess sphincter tone. In females, a pelvic exam will also be performed.
While blood tests are not usually needed to make the diagnosis, other tests may be helpful in deciding the potential cause of fecal incontinence. Anal manometry measures the pressure within the rectum, both at rest and when the patient squeezes the anal sphincter. Nerve and muscle conduction studies may be considered. Ultrasound can evaluate the anal sphincters and look for muscle damage.
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