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Fecal Incontinence

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What is Fecal Incontinence?

Fecal incontinence—also known as bowel incontinence—is the inability to control bowel movements, resulting in feces (stool) to leak out of the rectum. Fecal incontinence may be accompanied by other gastrointestinal problems, including:

Constipation
Diarrhea

What are the Causes of Fecal Incontinence?

For many patients, there may be more than one cause for fecal incontinence. Causes may include:

Chronic constipation. A backup of hard, dry feces lodged in the rectum can stretch and weaken the walls of the intestine. This can allow watery feces to move around in the hard stool and leak out of the anus. Chronic constipation may also cause nerve damage that leads to fecal incontinence
Loose feces is harder to retain in the rectum than hard feces, which can lead to leakage
Loss of space in the rectum. Loss of storage space in the rectum can occur when the walls of the intestine are scarred or hardened due to radiation, surgery or inflammatory bowel disease. As a result, the walls are unable to stretch, and feces may leak out
Muscle damage. Injury to the anal sphincter—which typically happens during childbirth—can make it challenging to keep feces in
Nerve damage. Injury to the nerves that cause the urge to defecate or those that control the anal sphincter can lead to leakage. Nerve damage may be the result of childbirth, trauma or disease, such as multiple sclerosis
Rectal prolapse. Rectal prolapse occurs when the rectum drops down through the anus
In women, fecal incontinence can also be due to the rectum protruding the vaginal wall
Surgery to treat enlarged veins in the anus/rectum (hemorrhoids). Surgery to treat hemorrhoids may result in muscle or nerve damage

Groups at risk for developing fecal incontinence include:

Middle-aged and older adults
Patients with dementia
Patients with nerve damage
Physically disabled patients
Women

What are the Symptoms of Fecal Incontinence?

In the majority of adults, fecal incontinence only occurs during an occasional bout of diarrhea. However, some patients live with chronic incontinence, which can be broken down into two categories:

Urge incontinence: Patients are unable to resist the very sudden urge to defecate in time to make it to the restroom
Passive incontinence: Patients do not get the sensation that they need to know when to go to the restroom

How is Fecal Incontinence Diagnosed?

Tests to confirm the diagnosis of fecal incontinence include:

Anal manometry. A small, flexible tube with a balloon at the end is inserted into the rectum. The balloon is then inflated, and the pressures of the muscles and the neural reflexes are recorded and evaluated
Anorectal ultrasonography. A wand-shaped instrument is inserted into the anus to produce a video image of the rectum
Balloon expulsion. A small balloon is inserted into the rectum and filled with water. Patients are then asked to secrete the balloon. The amount of time that it takes for the balloon to exit the body is recorded and assessed
A small, flexible tube with a camera at the end is inserted into the anus to view the inside of the rectum and lower intestine for any abnormality
Digital rectal exam (DRE). A physician inserts a gloved, lubricated finger into the anus to feel for any abnormality and evaluate anal sphincter strength
Flexible sigmoidoscopy. A small, flexible tube with a camera at the end is inserted into the last portion of the colon known as the sigmoid colon to search for abnormality
Magnetic resonance imaging (MRI). MRI produces clear images of the sphincter to check for any deformity in the muscles during defecation
X-ray images are taken during a bowel movement on a special toilet to measure how much feces the rectum is able to hold

How is Fecal Incontinence Treated in NJ?

Treatment for fecal incontinence may include:

Taking medications, such as an anti-diarrheal (e.g., Imodium®), bulk laxatives (e.g., Citrucel®) or injectibles inserted into the anal canal
Dietary changes, including eating more fiber and drinking more fluids
Biofeedback exercises to increase muscle strength
Sacral nerve stimulation (SNS), which uses an implanted device to send extra signals to the nerves that control the bowel
Surgery, which is typically required for fecal incontinence only when correcting an underlying condition, such as rectal prolapse or sphincter trauma from childbirth

Treatment for Fecal Incontinence in NJ from DHC

If you are experiencing symptoms of fecal incontinence, we encourage you to reach out and schedule an appointment at Digestive Healthcare Center today. Our team of compassionate and experienced gastroenterologists will work with you to address the issue and create a treatment plan with your needs in mind. We will ensure that you understand the “why” behind all decisions made for your health. To learn more about our gastroenterology services in NJ, please contact us today.

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Digestive Health Care and Treatment in New Jersey

Digestive Healthcare Center proudly provides comprehensive care at our three office locations in Hillsborough, Somerville, and Warren, NJ. We will work with you to diagnose any condition that is present and help you find relief. We accept appointments in person at our offices, as well as convenient telemedicine virtual visits from the comfort of your home.