Fecal Incontinence

Treatment

These treatment options are available to patients at Mayo Clinic. Treatment decisions are based on the severity of each patient's condition.

Dietary Changes

Mild fecal incontinence can be treated with dietary changes. Physicians and dietitians at Mayo Clinic help patients make necessary changes.

Medications

Medications can improve stool form in patients with diarrhea or loose stools.

Muscle Exercises

Physicians and therapists at Mayo Clinic can help patients learn simple exercises that increase anal muscle strength.

Biofeedback Retraining

Specially trained physiotherapists help patients relearn bowel movement techniques with biofeedback. This process helps patients strengthen the related muscles, sense when stool is ready to be evacuated and contract the muscles if evacuation is inconvenient.

Surgical Repair of the Anal Sphincter

In patients who have significant fecal incontinence with damage to the muscles but not to the nerves of the anal sphincter, surgery may be the best option. Surgical options include:

• A sphincteroplasty to repair the damaged or weakened anal sphincter
• Surgical repair of rectal prolapse, rectocele or hemorrhoids
• A colostomy to divert the stool into a special bag (used only as a last resort)

An overlapping sphincteroplasty is the repair of choice at Mayo Clinic. In this procedure, surgeons bring the separated muscles back together and overlap them to complete the circular sphincter muscle. In the short term (one to two years), success rates are high. However, continence does not last in many cases; several studies have shown that 40 percent or less of patients are still continent five years after the procedure.

The minimally invasive Secca procedure is offered at Mayo Clinic in Arizona. Radiofrequency energy is used to burn the inside of the rectum. After the burns heal, the rectum is less prone to incontinence in some patients.

Urogynecologists at Mayo Clinic in Florida are evaluating sacral nerve stimulation, an FDA-approved treatment for urinary incontinence, in patients with fecal incontinence.

Less common procedures may be considered for complex injuries, such as extensive nerve damage. Successful repair depends upon the severity of the injury, how long the patient has had it and whether an infection is present.

Colon and rectal surgeons at Mayo have completed training in general surgery as well as advanced training in the treatment of colon and rectal problems. They are board certified by the American Board of Surgery and the American Board of Colon and Rectal Surgery.