Patients with fecal incontinence have trouble controlling gas or bowel material. It’s a condition that can impact women 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 women, this is a frequent reason for placement in a nursing home.
Fecal incontinence affects an estimated 1 out of 13 women younger than 60 and 1 out of 7 women older than 60 years old.
University of Michigan Health System physicians provide comprehensive surgical and non-surgical services for women suffering from fecal incontinence. We see women of a range of ages, including some women who have this condition shortly after childbirth extending into women who are having problems at an older age.
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, usually starting with a pelvic exam that includes an examination of your rectum and anus may be done to look for hemorrhoids and prior scarring, plus test the strength of your muscles and your ability to squeeze those muscles
- In addition, other exams may be performed to accurately diagnose the type and cause of 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, and also the nerves in your back, which are important to bowel control
- Defecography: uses x-ray to see what is happening as you have a bowel movement, and if there are blockages or pelvic organ prolapse
- 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
Fecal Incontinence Treatment
Treatment options depend on type of incontinence, the cause and severity. In some cases, treatment may be as simple as lifestyle and diet modifications. Some women do physical therapy to strengthen and retrain your pelvis and sphincter muscles. Electrical stimulation can help strengthen your muscles. You may be prescribed one of several medications. There are also a variety of surgeries of that may help your particular fecal incontinence 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 a woman’s life, 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.
Take the Next Step
To schedule an appointment or learn more about the University of Michigan Bowel Control Program, call 734-615-7380.