Fecal Incontinence Treatment

Understanding faecal incontinence

Faecal incontinence means accidental leakage of stool or wind. It ranges from occasional staining of underwear to complete loss of bowel control. It is more common than many people realise and is often not discussed because of embarrassment, but it can usually be improved with the right treatment.

Causes

• Injury to the anal sphincter muscles during childbirth, especially after a difficult delivery
• Previous anal surgery such as fistula or fissure operations
• Nerve damage from diabetes, spinal problems or long-term straining
• Chronic diarrhoea, irritable bowel syndrome or inflammatory bowel disease
• Rectal prolapse
• Constipation with overflow of loose stool
• Weakening of muscles with age

How it is assessed

Your doctor will ask about how often leakage happens, what type of stool leaks, and how it affects daily life, and will examine the area. Tests may include anorectal manometry to measure sphincter strength, endoanal ultrasound to look for a defect in the muscle, and colonoscopy if there has been a change in bowel habit.

Treatment options

1. Diet and stool consistency: firming loose stools with fibre and, where needed, medicines such as loperamide often makes a large difference.
2. Bowel habit training and pelvic floor exercises.
3. Biofeedback therapy to strengthen and coordinate the sphincter muscles.
4. Sphincteroplasty: surgical repair of a torn sphincter muscle, often helpful after childbirth injury.
5. Sacral nerve stimulation: a small implanted device that stimulates the nerves controlling the bowel, considered when other treatments have not helped.
6. Treatment of contributing conditions such as rectal prolapse or diarrhoea.

Living with incontinence

While treatment takes effect, practical steps help: keeping to a regular toilet routine, avoiding foods that loosen stool, using barrier creams to protect the skin and carrying a small change kit. Speaking openly with your doctor is the first step to improvement.

Frequently asked questions

Is faecal incontinence a normal part of ageing?

No. It becomes more common with age, but it is a medical problem that can usually be improved.

Can childbirth injury be repaired years later?

Yes. Sphincter repair can be done even years after delivery if tests show a defect in the muscle.

What is sacral nerve stimulation?

It is a treatment in which a thin wire is placed near the nerves at the base of the spine and connected to a small device under the skin. It is usually tested first before permanent implantation.

Related pages

• Sphincteroplasty
• Sacral nerve stimulation
• Rectal prolapse
• Dr. Ashok Kumar, Surgical Gastroenterologist

Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.