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What is fecal incontinence?

Fecal incontinence means absent or insufficient voluntary control over defecation. It involves a range of symptoms, from mild trouble holding gas to severe difficulty

holding formed stools. Many people are shy and embarrassed to talk about incontinence, but treatment options are available for this condition.

What causes fecal incontinence?

Injury to the anal muscles or sphincters due to childbirth (more common cause), anal or rectal operation or trauma.

Anal nerve damage due to pregnancy, childbirth or constant straining.

Neurological disease, such as stroke.

Age-related loss of anal muscle strength.

Loose stools.

Leakage accompanied by blood in the stool may indicate inflamma­tion (colitis), rectal tumor or rectal prolapse. These conditions require prompt evaluation.

How is the cause determined?

Detailed medical history which includes:

• Medical illnesses and medications

• Bowel habits and other bowel symptoms

• In women, history of past childbirths

Physical examination of the anal region

Additional studies, as necessary

• Anal manometry

• Defecography

• Pelvic nerve testing

• Endoanal ultrasonography


Treatment is based on the underlying cause:

• Medications – for cases caused by a medical illness, such as bowel infection or inflammation.

• Surgery – for incontinence caused by injury to the sphincter muscles.

• Dietary changes and pelvic floor muscle exercises – if the muscles are intact but are functioning poorly.

For uncorrectable causes of incontinence, different measures may be recommended to make the problem more manageable:

• Enemas or rectal irrigation – help empty the bowel and reduce the chance of leakage.

• Medications – can help control diarrhea.

• Fiber supplements – usually improve constipation.

• Colostomy – may help improve quality of life in patients with severe, life-debilitating incontinence.

Painful skin irritation associated with incontinence may be addressed in various ways. Details may be discussed with your specialist.

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