Fecal incontinence is the inability to control flatus and bowel movements. It can range from occasional leakage of stool and/or gas to complete loss of bowel control. This can be identified in people when they perceive involuntary gas leakage, discover traces of fecal matter in their underwear, anal wetness and even force themselves to wear diapers permanently.

Fecal incontinence can have a significant impact on the daily lives of those who suffer from it, causing discomfort, insecurity and a major obstacle to carrying out daily activities, even forcing them to “bury themselves alive” inside their homes.

Fecal incontinence may be due to multiple causes, among which the following stand out:

Anatomical defects:

• Obstetric tears
• Gynecological surgeries
• Anal surgeries such as: hemorrhoids, fistulas or fissures.
• Rectal prolapse
• Pelvic floor dysfunction

Diseases such as:

• Parkinson's disease, dementia, schizophrenia, etc.
• Scleroderma, Diabetes
• Demyelinating diseases
• Cerebrovascular disease
• Spinal cord trauma

Habits:

• Alcoholism
• Diet
• Obesity
• Constipation
• Laxative abuse

How to detect fecal incontinence?

There is no doubt that fecal incontinence is a very challenging, embarrassing, embarrassing and embarrassing condition that is rarely talked about and socialized. However, understanding its causes and symptoms is essential to deal with this problem effectively. Especially because it can manifest itself in different ways and with varying degrees of severity.

Thus, fecal incontinence not only presents as an involuntary leakage of stool, but can also generate a sudden and uncontrollable urge to defecate, with the worry of not getting to the bathroom in time. In addition, you may experience a persistent feeling of having more stool in your rectum, even after you have had a bowel movement.

Medical care: key to accurate diagnosis

In case of any of the symptoms, medical attention by specialists is essential to establish the origin of the discomfort and recommend the appropriate treatment according to the diagnosis. For this purpose, the professionals perform a complete physical examination, based on the medical history. The success of the diagnosis and the suggested treatment is the open and clear communication about the intensity and frequency of the symptoms. If information is omitted, no matter how simple and insignificant it may seem, the specialist performing the assessment will have fewer tools to find the cause of the alteration.

Because fecal incontinence can be due to a variety of conditions, your doctor will perform a digital rectal exam in addition to a general physical examination. This involves inserting a gloved, lubricated finger into the rectum. This exam evaluates the strength of the anal muscles and the presence of any abnormalities.

Other tests are ordered selectively and accordingly to evaluate the colon, rectum, anal muscles, and pelvic floor muscles such as:

• Rectosigmoidoscopy/Colonoscopy A thin, lighted instrument called a colonoscope is inserted into the anus to examine the rectum and/or the entire colon. This test helps your doctor find areas of inflammation, bleeding, ulcers, tumors and polyps.
• Anal manometry. This test evaluates the pressure in the intestinal canal and rectum, and the strength of the anal muscles. In addition, rectal capacity, sensitivity and distensibility are evaluated by insufflating a balloon with water into the rectum and simulating a defecation while trying to expel it.
• Endoanal ultrasound. An ultrasound probe is inserted into the anus and rectum which generates images. This test helps evaluate for tears in the anal muscles and/or anatomical abnormalities or injuries.
• Electromyography (EMG). This test uses a needle electrode to evaluate nerve conduction within the anal sphincter and pelvic floor muscles as well as to determine the electrical activity of the sacral neural arch.
• Magnetic resonance defecography (MRI). MRI produces detailed anatomical information and images of how the rectum and pelvic floor look and function during the different phases of defecation (rest, straining, contraction).

Treatment will depend on the underlying cause of your condition. There are multiple treatment options that vary depending on the underlying cause and severity of symptoms, for example:

• Dietary adjustments to regulate bowel movements, such as increased fiber and fluid intake.
• Pelvic floor strengthening exercises or biofeedback can improve muscle control and coordination in the affected area by up to 70%. Retraining with pelvic floor exercises restores, strengthens and increases muscle control and proprioception over the pelvic floor muscles.
• Fecal bolus-forming drugs or drugs that help a more efficient contraction of the anal sphincter. But also antidiarrheals, when there is diarrhea with fecal incontinence, and laxatives for constipation associated with incontinence.
• Sacral nerve stimulation implants a device inside your body to stimulate the nerves and prevent fecal incontinence.
• Surgery to strengthen and repair damage to the pelvic floor muscles and anal sphincter or correction of anatomical conditions (rectal prolapse, rectocele, etc.).
• Perform a colostomy and divert stool into an external bag where it accumulates.

The specialist may recommend one of these options as treatment or combine them to achieve better results. The most important thing is that you comply with everything that is ordered, so that you can regain control of your bowel movements and with it, your quality of life.

If you have symptoms or want an assessment of your anorectal health, at the ICO Institute of Coloproctology, we specialize in the diagnosis and treatment of diseases involving the colon, rectum and anus, and we are prepared to guide you and bring you relief. Make an appointment here.