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Bowel incontinence (also referred to as fecal incontinence) is the inability to control bowel movements, gas, or stool. This condition can be mild to severe, ranging from the inability to control gas expulsion to complete loss of control over liquid or formed stools. According to the American Society of Colon and Rectal Surgeons, approximately 2% of women are affected by this condition.
While many things may contribute to the development of bowel incontinence, injury during childbirth is the most common cause. Anal operations or trauma may also cause bowel incontinence. Advancing age may lead to the loss of strength in the anal muscles which creates an issue with controlling stool evacuation. A physical exam is needed to properly diagnose and treat fecal incontinence. Your doctor may suggest an anorectal manometry test first, in order to measure the strength and function of the anal sphincter muscles and neural reflexes that are used during a bowel movement. A small, flexible device is inserted painlessly into the rectum. The patient then squeezes and relaxes the anal sphincter muscles. If the muscles tighten or relax at the wrong time it likely indicates incontinence or constipation.
Due to the fact that this condition occurs most frequently in women who have given birth, risk factor most often include multiple vaginal births, large weight babies, and forceps deliveries. Episiotomies during birth may also be a contributing factor.
Acute, or short-term incontinence, will often cause occasional bouts of diarrhea. Chronic, on-going bowel incontinence usually produces these symptoms:
Typically combinations of techniques are used that may include dietary changes, medications, biofeedback, surgical intervention, muscle strengthening exercises, or possibly an artificial anal sphincter.
Your colorectal surgeon may advise a treatment called sacral nerve stimulation which sends electrical impulses to the nerves to help control sphincter movements. If all other measures are unsuccessful, extreme cases may be treated by creating a colostomy.