Understanding Fecal Incontinence

Fecal incontinence — inability to control bowel movements — affects millions of people but is rarely discussed. Causes include obstetric anal sphincter injury (tear during childbirth), previous anorectal surgery, diabetes-related neuropathy, rectal prolapse, and pudendal nerve damage. Dr. Ashok Kumar has published research on fecal incontinence and offers comprehensive treatment at Charak Hospital.

Treatment Options

• Sphincteroplasty — surgical repair of torn or disrupted external anal sphincter. Suitable for obstetric injuries. Good short-term results in 70% of patients.
• Sacral Nerve Stimulation (SNS) — a minimally invasive implantable device that modulates the nerves controlling the sphincter and rectum. Highly effective for neurogenic incontinence and post-sphincteroplasty failures.
• Dynamic Graciloplasty — transposition of the gracilis muscle of the thigh around the anus for severe refractory cases.
• Antegrade Continence Enema (ACE) — for neurogenic incontinence in carefully selected patients.
• Conservative management — biofeedback, pelvic floor physiotherapy, dietary fibre, bulking agents and anti-diarrhoeal medication for mild-moderate incontinence.