What is Fecal Incontinence?

Fecal incontinence is the inability to control bowel movements, leading to unexpected leakage of stool. It affects millions of people but is rarely discussed due to embarrassment — leading to social isolation, depression and severely impaired quality of life. Effective treatments are available at Charak Hospital.

Causes

• Obstetric anal sphincter injury (third/fourth degree perineal tear during childbirth)
• Previous anorectal surgery (haemorrhoidectomy, fistula surgery)
• Rectal prolapse causing sphincter stretch injury
• Pudendal neuropathy (nerve damage from childbirth, diabetes, ageing)
• Radiation proctitis after pelvic radiotherapy
• Inflammatory bowel disease causing urgency and liquid stool

Treatment Ladder

• Conservative — dietary modification (bulking agents, loperamide), pelvic floor exercises, biofeedback, scheduled toilet training
• Sphincteroplasty — surgical repair of torn external anal sphincter; best for post-obstetric injury with identified defect on endoanal ultrasound
• Sacral Nerve Stimulation (SNS) — implantable neuromodulation device; most effective for neurogenic incontinence and failed sphincteroplasty
• Injectable bulking agents — for minor passive leakage; minimally invasive office procedure
• Dynamic graciloplasty / artificial bowel sphincter — for severe cases with complete sphincter absence