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Many people are too embarrassed to talk about fecal incontinence, so they don’t get the help they need. UW Health surgeon, Dr. Ray King, wants to bring awareness to this common condition and the fact that it’s very treatable through various approaches. Read on to learn about bowel incontinence and how you can put an end to it.
What causes bowel incontinence?
Bowel incontinence is the inability to control your stool or gas. It can be caused by damaged pelvic floor muscles or a problem with the nerves that send messages between the pelvis and the brain.
The pelvic floor is a group of muscles, tissue and ligaments that help support the bladder, uterus, and rectum. The anal sphincter is part of the pelvic floor and can become damaged during childbirth, or weakened through normal wear and tear and aging. Other conditions, such as diabetes, multiple sclerosis (MS) and history of pelvis surgery can contribute to nerve dysfunction that leads to bowel incontinence.
You can experience bowel incontinence in a few different ways:
Unexpectedly or uncontrollably passing gas
Having a sudden urgent need to have a bowel movement and not be able to make it to the bathroom
Never feeling the sensation of a bowel movement (not knowing until after it occurs)
Some people experience a sudden onset of bowel incontinence when they have a torn muscle or other trauma. Others lose bowel control more gradually. It might start with uncontrolled passing of gas, followed by random uncontrolled bowel movements and then progress to more regular stool leakage.
When should I talk to a doctor about bowel incontinence?
There’s no need to rush to a doctor if you have a random accident. However, if it seems to be occurring regularly or negatively affecting your quality of life, don’t hesitate to schedule an appointment.
“Fecal incontinence usually does not get better on its own. In fact, if not addressed, it can progressively worsen,” Dr. King says.
Left untreated, bowel incontinence can have a major impact on mental health and quality of life. Fear of uncontrollable bowel movements can cause anxiety and depression, as well as social isolation. Some people with bowel incontinence find themselves unable to work and develop skin infections resulting from repeatedly soiling of clothing.
How is bowel incontinence diagnosed and treated?
Your doctor will discuss your health history and symptoms with you and conduct one or more examinations:
Physical exam – digital rectal exam to determine resting tone of your anal sphincter and ability to squeeze
Anorectal manometry – uses a mechanical measuring device that evaluates anal sphincter function
Endoanal ultrasound – looks for defects in the anal sphincter
Pelvic MRI – evaluates sphincter and pelvic organ issues
Bowel incontinence treatment is highly successful for most people
Treatment options include:
Dietary changes – Adding more fiber to your diet will create bulkier stool that is easier to control. Your doctor can also review your medications and foods to look for possible triggers.
Pelvic floor physical therapy – Physical therapists can help you strengthen and coordinate pelvic floor muscles that assist with bowel movements.
Sphincteroplasty – This is a surgical procedure that repairs damaged sphincter muscles.
Sacral nerve neuromodulator – This is a small implantable device that is placed in an outpatient surgery. It stimulates the nerves that help with sensation and muscle contraction. It has a greater than 90% success rate.
Colostomy – This procedure is only used in patients who have not responded to any other treatment options. The surgeon creates an opening in your abdominal wall (belly) for waste (stool) to go into a special colostomy bag.
How the Integrated Specialty Care for Women program can help
Did you know that women are more likely to develop bowel incontinence than men?
“The muscles of the male pelvic floor is typically more robust than the female pelvic floor.” Dr. King says. “Additionally, childbirth is a common cause of pelvic floor damage.”
Don’t let it take over your life. Treatment is available and highly effective.
The UW Health Integrated Specialty Care for Women program gives women a convenient “one-stop shop” for pelvic floor wellness. Since bowel incontinence often goes hand-in-hand with bladder incontinence and other pelvic conditions, you may need the expertise of multiple medical specialists. Through UW Health, you will receive coordinated multidisciplinary care with just one appointment. Let us help you get back to work, friends and fun without worry.