Fecal incontinence, also called stool incontinence, is the inability to control the passage of stool or gas, which can be a socially and emotionally disabling problem for patients and their families. In addition, it is often a common reason for institutionalizing elderly people.

Possible Causes

Some of the possible causes of fecal incontinence include:

• Constipation
• Diarrhea
• Damage to the muscles that compose the anal sphincter
• Nerve damage to the anal sphincter muscles or the rectum
• Change in storage capacity in the rectum (due to surgery or disease)
• Pelvic floor dysfunction (problems with the functioning of the muscles that control urination and defecation)

Diagnosis

We provide state-of-the-art testing to determine the cause of a patient’s incontinence including:

• Anal manometry checks the tightness of the anal sphincter and its ability to respond to signals, as well as the sensitivity and function of the rectum.
• Anorectal ultrasonography evaluates the structure of the anal sphincters.
• Defecography, also known as proctography, shows how much stool the rectum can hold, how well the rectum holds it, and how well the rectum can evacuate the stool.
• Proctosigmoidoscopy allows doctors to look inside the rectum for signs of disease or other problems that could cause fecal incontinence, such as inflammation, tumors or scar tissue.
• Anal electromyography (EMG) tests for nerve damage, which is often associated with obstetric injury to the anus.

Treatment

Treatment may include modifying diet and using medication to thicken stool and slow down its passage.

In some cases, surgical reconstruction of the sphincter muscle may be required, especially for patients whose incontinence is due to an obstetrical injury or prior anal surgery.

If the muscle cannot be repaired, an artificial sphincter can be implanted. The artificial anal sphincter provides a means of controlling stool for patients whose only other hope may have been a colostomy. The artificial anal sphincter resembles the product inserted for urinary incontinence, which has been used for many years with a high degree of success.