What Is Fecal Incontinence?

By Salim Amrani, MD

Fecal or bowel incontinence is a term that describes the inability to control wind or feces. In other words passing stool or gas at the wrong place and time.

It is a common condition especially in the elderly. Many patients feel too embarrassed to discuss the symptoms with a physician. Although it might not be life threatening, it causes a significant diminution in one’s quality of life.

It is the second most common cause of placement in a nursing home in the elderly.

There are many reasons to develop fecal incontinence some of them are related to increased intestinal propulsion such as in inflammatory bowel disease or could be due to incompetence of the anal sphincter from traumatic injuries such as having babies previously, and neurologic disorders or could be due to reduced capacity of the rectum from a previous radiotherapy.

In any case, after discussing the symptoms with your physician an attempt to gauge the severity of the condition is obtained by answering simple questions by using validated questionnaires. This will help the specialist determine if further testing is necessary and explore the different options that are available to improve the condition.

There have been several advances in the understanding and management of this condition in the last decade. If needed an anal physiology testing as well as an anal ultrasound will help your colon and rectal specialist determine how your sphincter works and if it has been damaged during previous pregnancies.

During these tests that are performed in the specialist office a small probe is introduced inside the anal canal. The test only takes few minutes and do not require anesthesia or a full cleaning of the colon.

A plan of care will then be established and a follow up will assess the response to therapy.

The treatments ranges from simple measures such as improving the diet, exercise programs and anti-diarrhea medications to advanced surgical procedures involving anal muscle repair, anal canal re-enforcement with injectable products  or nerve modulation amongst others.

People with fecal incontinence should not be feeling alone as there are ways to restore confidence and freedom.