Fecal Incontinence

Patients with fecal incontinence have trouble controlling gas or bowel material. It’s a condition that can impact people of all ages for various reasons and is very embarrassing and bothersome. Patients find that fecal incontinence interferes with their ability to work, exercise and enjoy social activities. In older people, this is a frequent reason for placement in a nursing home.

Fecal incontinence increases with age, affecting an estimated 1 out of 13 women younger than 60 and 1 out of 7 women older than 60 years old. While many may think this only affects women, a recent review of 38 studies found that the prevalence of fecal incontinence was roughly equal between men and women (~8 out of 100). 

Fecal incontinence is also prevalent in people who have neurologic disorders (spinal cord injury, spina bifida, multiple sclerosis, stroke, traumatic brain injury, etc.) or muscle impairments (peripheral nerve injury or neuropathies, muscular dystrophy, myasthenia gravis, etc.) related to weakness and/or discoordination of the rectal sphincters and the pelvic floor muscles. 

University of Michigan Health physicians provide comprehensive surgical and non-surgical services for people suffering from fecal incontinence. We see people of all age ranges, including women who have this condition shortly after childbirth.

There are different types of anal incontinence, including:

  • Flatal incontinence – the inability to control the passage of gas
  • Fecal incontinence – the inability to control the passage of liquid or solid stool
  • Double incontinence – the inability to control both the passage of stool from the rectum and urine from the urethra (the tube that urine travels through)
  • Rectovaginal fistula – when a connection develops between the vagina and rectum, resulting in stool being passed through the vagina

Diagnosing Fecal Incontinence

Many tests are available to help diagnose the different forms of fecal incontinence. Examination of your rectum and anus may be done to look for hemorrhoids and prior scarring, as well as to assess the strength of your muscles and your ability to squeeze those muscles. For women, a pelvic exam of the vaginal canal is often needed as well as disorders in this area can affect both urinary and fecal incontinence.

In addition, other exams may be performed to accurately diagnose the type and cause of incontinence:

  • Defecography – uses X-ray to see what is happening as you have a bowel movement and if there are blockages or pelvic organs pushing into your anus or rectum
  • Anal manometry – determines if the muscles of the rectum are strong and functioning properly
  • Colonoscopy – in addition to screening for colon cancer, colonoscopy can help detect other bowel problems that could be contributing to incontinence
  • Transanal ultrasound – looks at your anal sphincter, which is the muscle that allows you to control your bowel movements
  • MRI – looks at the muscles of the pelvic floor, which help control your bowel movements, as well as the nerves in your back, which are important to bowel control

Fecal Incontinence Treatment

Treatment options depend on the type of incontinence, the cause and the severity. In some cases, treatment may be as simple as lifestyle and diet modifications. For some, treatment may include physical therapy to strengthen and retrain pelvic and sphincter muscles. Electrical stimulation also can help strengthen your muscles. You may be prescribed one of several medications. There are also a variety of surgeries that may help your particular symptoms.

The Michigan Bowel Control Program (MBCP) is a unique program dedicated to caring for individuals with bowel disorders, including fecal incontinence. To address the complexity of causes of fecal incontinence and the impact it can have on people’s lives, MBCP provides a multidisciplinary consultation service with nurses and physicians from the departments of colorectal surgery, gastroenterology, gynecology, psychiatry, radiology, nursing and physical therapy. Our combined efforts allow for individualized approaches to improve patient care.

Additional Resources

Make an Appointment

To schedule an appointment or learn more about the Michigan Bowel Control Program, call 734-763-6295 #3.