Fecal incontinence is the inability to control the passage of stool. In individuals who usually have normal bowel habits, fecal incontinence may occur only when they have an occasional bout of severe diarrhea.
Other people have a problem with fecal incontinence on a chronic basis, due to the inability to sense that they need to move their bowels, or because the urge to defecate is so sudden that they cannot get to the bathroom in time.
There are many causes of fecal incontinence:
- Muscle damage to the anal sphincter muscle fibers. The most common example is damage from childbirth due to an episiotomy or forceps delivery.
- Nerve damage to the rectal or anal sphincter area nerve supply.
- Constipation over a long period of time can cause rectal muscles to stretch and weaken.
- Diarrhea can cause fecal incontinence, since it is easier to pass loose stool than harder stool.
- Poor rectal function, due to damage after surgery in that area, radiation or inflammatory bowel disease can lead to decreased storage area and cause fecal incontinence.
- Surgery to the rectum or anal area can cause fecal incontinence due to loss of muscle or nerve integrity in those areas.
- Abnormal rectal conditions, such as rectal prolapse (whereby the large intestine protrudes from the rectum) or rectocele (whereby the wall of the rectum protrudes through the wall of the vagina).
Risk factors for developing fecal incontinence include advanced age, female sex (often childbirth related injuries), diabetes, certain neurological conditions such as multiple sclerosis or degenerative muscle conditions, dementia or other mental disabilities and other physical disabilities.
There are treatments available for fecal incontinence. This may require special testing to determine the cause. Improving bowel function to correct constipation or diarrhea may help. Sometimes, specific exercises learned through biofeedback techniques are helpful. Surgery may be necessary. There are special anal sphincter nerve stimulators and injectable agents that can bolster a weak sphincter.
Getting the help you need requires discussing your symptoms with your physician. Although fecal incontinence if often very embarrassing, your physician has the ability to help you understand this problem, evaluate it to determine the cause(s) and provide further treatment suggestions for you.
