Siouxland GI Surgery 

​Colorectal Surgery

FECAL INCONTINENCE

 

Fecal incontinence – is the impaired ability to control stool. Stool leaks out of the rectum at unwanted times with or without your knowledge. Fecal incontinence happens more often in women than in men and also is a common occurrence in the elderly.

It can manifest as
- Stool leaking out when passing gas
- Stool leaking out due to physical activity/daily life exertions
- A person may “feel like he/she has to go” and not be able to make it to the bathroom in time
- Stool is seen in the underwear after a normal bowel movement
- There is complete loss of bowel control


FACTORS AFFECTING THE ABILITY TO CONTROL BOWEL MOVEMENT:
Muscles in anus called sphincters.
Rectal compliance (ability to stretch and hold stool)
Rectal sensation to provide warning about the stretching of rectum.
Stool consistency


CAUSES FOR INCONTINENCE
- Diarrhea, watery stools
- Muscle damage during prolonged or multiple childbirth
- Old age
- Nerve damage (Diabetes, Spine abnormalities)
- Loss of rectal compliance- (IBD, Radiation proctitis)
- Other medical conditions. Certain medical conditions, such as rectal prolapse (the rectum falls down into the anus) or rectocele (the rectum pushes into the vagina), or chronic constipation where stool leaks around a large stool ball.


INVESTIGATIONS
- Anorectal physiology testing - Anal manometry, Endoluminal ultrasound, Pudendal nerve terminal motor latency test, Anal electromyography (EMG).
- Flexible sigmoidoscopy
- Defecography with MRI or barium


TREATMENT
Depending on the cause of fecal incontinence, treatment can include one or more of these approaches: dietary changes, bowel training, medications, or surgery.

Non Surgical treatment -
Dietary changes - avoid foods that may cause loose stools (caffeine, alcohol, prunes, beans, cabbage family vegetables, spicy foods, dairy products, cured or smoked meats and artificial sweeteners). Other foods help thicken the stool, which may help fecal control (include bananas, apple sauce, peanut butter, pasta, potatoes and cheese).

Enemas – to empty bowels at fixed times under control

Bowel training - certain pelvic floor exercises (Kegel)  that can strengthen the muscles around the anus. A trained therapist can teach you how to locate the correct muscles and perform the exercises. This process is called biofeedback.

Medications -  anti-diarrheal drugs and fiber supplements to thicken the stools

Skin protection - barrier creams -- such as those used for baby’s diaper rash –

 
Surgical options -
Sphincteroplasty or overlapping sphincter repair, sews damaged sphincter muscles back together.

Bulking agents – Injecting silicone

Sacral nerve stimulation – Constant electrical stimulation of the sacral nerves.

Colostomy – when all other treatment fails the colon is brought to the surface of the skin.


















Click here to open in PDF format for printing

Call Us:  712 234 8725