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 is the treatment for bowel incontinence?
The treatment approach for a patient with fecal incontinence is individualized based upon the underlying cause. The purpose is to regulate bowel movements, decrease their frequency, and increase stool firmness and consistency. Often this involves dietary changes and the use of medications that bulk the stool.
Increasing the strength of the muscles of the pelvic floor might be helpful. Kegel exercises and electrical stimulation may be recommended. Biofeedback is often used to help retrain the anal sphincters and have the patient appreciate the sensation of rectal fullness that comes just before the need to defecate.
If the incontinence persists even after maximum medical therapy has been attempted, surgery may be an alternative. If damaged, attempts can be made to repair the muscles of the pelvic floor including the external anal sphincter. The internal anal sphincter function may be enhanced by injecting materials like silicone, carbon beads, or collagen.
As a last resort, where all other options have failed, a colostomy may be performed, where the colon is diverted through the abdominal wall to empty into a removable bag.
What about bowel incontinence in children?
In children, fecal incontinence (also called encopresis) is often due to chronic constipation and overflow incontinence or diarrhea. By definition, there should be at least one inappropriate bowel movement per month for at least three months in a child older than age 4 years. The incontinence usually happens during the day and not at night.
Most often, the diagnosis is made by history and physical examination by the health care professional and further testing is not needed.
Treatment is directed at developing a more routine bowel evacuation schedule and may require changes in diet, behavior modification, and the addition of stool bulking agents.
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