Fecal Incontinence

Diagnosis

After carefully listening to your history, your doctor will do a physical examination, which will include a digital exam of the rectum to check for muscle strength and irregularities as well as using a pin or probe to check for nerve damage.

Your doctor will use a variety of tests to fully understand your problem. Many of these tests were developed or validated at Mayo Clinic. The tests used most frequently are:

• Anal manometry — A catheter with pressure sensors and a small inflatable balloon is inserted into the anus and rectum to test the strength of the anal sphincter as well as the sensitivity and function of the rectum.
• Anorectal ultrasonography — A small device (transducer) is inserted into the rectum to visualize the internal structure of the rectum and sphincter using sound waves.

Other tests

• Proctography (defecography) — X-ray video images are made while you defecate on a specially designed toilet. The test evaluates the capacity of your rectum and how well your body expels stool.
• Proctosigmoidoscopy —A long, slender tube containing a video camera is inserted into the rectum and sigmoid colon (approximately two feet of colon). This is helpful for finding tumors, infections, inflammation or other problems that may influence fecal incontinence.
• Anal electromyography (EMG) —Tiny needle electrodes are inserted into the muscles around the anus to check for nerve damage.
• Pelvic MRI — Magnetic resonance imaging scans of the pelvis show the anal sphincter and pelvic floor muscles, and also evaluate if the pelvic floor muscles move normally.