Depending on the cause of fecal incontinence, the options include:
- Anti-diarrheal drugs
- Laxatives, if chronic constipation is causing your incontinence
- Medications to decrease the spontaneous motion of your bowel
Stool consistency is affected by what you eat and drink. Your doctor may recommend drinking plenty of fluids and eating fiber-rich foods, if constipation is causing fecal incontinence. If diarrhea is contributing to the problem, high-fiber foods can also add bulk to your stools and make them less watery.
Exercise and other therapies
If fecal incontinence is caused by muscle damage, your doctor may recommend a program of exercise and other therapies to restore muscle strength. These treatments can improve anal sphincter control and the awareness of the urge to defecate. The options include:
- Biofeedback. Specially trained physiotherapists teach simple exercises that can increase anal muscle strength. People learn how to strengthen pelvic floor muscles, sense when stool is ready to be released and contract the muscles if having a bowel movement at a certain time is inconvenient.
- Bowel training. Your doctor may recommend making a conscious effort to have a bowel movement at a specific time of day, for example, after eating. Establishing when you need to use the toilet can help you gain greater control.
- Sacral nerve stimulation. The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Implanting a device that sends small electrical impulses continuously to the nerves can strengthen muscles in the bowel. This treatment is usually done only after other treatments are tried.
Treating fecal incontinence may require surgery to correct an underlying problem, such as rectal prolapse or sphincter damage caused by childbirth. The options include:
Nov. 06, 2012
- Sphincteroplasty. This procedure repairs a damaged or weakened anal sphincter. An injured area of muscle is identified, and its edges are freed from the surrounding tissue. The muscle edges are then brought back and sewn together in an overlapping fashion, strengthening the muscle and tightening the sphincter.
- Treating rectal prolapse, a rectocele or hemorrhoids. Surgical correction of these problems will likely reduce or eliminate fecal incontinence.
- Sphincter replacement. A damaged anal sphincter can be replaced with an artificial anal sphincter. The device is essentially an inflatable cuff, which is implanted around your anal canal. When inflated, the device keeps your anal sphincter shut tight until you're ready to defecate. To go to the toilet, you use a small external pump to deflate the device and allow stool to be released. The device then reinflates itself.
- Sphincter repair. In this surgery a muscle is taken from the inner thigh and wrapped around the sphincter, restoring muscle tone to the sphincter.
- Colostomy. This surgery diverts stool through an opening in the abdomen. A special bag is attached to this opening to collect the stool. Colostomy is generally considered only after other treatments have been tried.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Oct. 2, 2012.
- Fecal incontinence. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/fecalincontinence/index.aspx. Accessed Oct. 3, 2012.
- Bharucha AE. Recent advances in functional anorectal disorders. Current Gastroenterology Report. 2011;13:316.
- Whitehead WE, et al. Diagnosis and treatment of pelvic floor disorders: What's new and what's to do. Gastroenterology. 2010;138:1231.
- Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-1-4377-1604-7..C2009-0-42832-0--TOP&isbn=978-1-4377-1604-7&uniqId=327451096-2. Accessed Oct. 3, 2012.
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