BOWEL CONTROL PROBLEMS

Overview & Facts

  • A loss of bowel control that results in involuntary fecal elimination.
  • Severity can range from an infrequent involuntary passage of small amounts of stool to a total loss of bowel control.
  • Some people with bowel incontinence feel the urge to have bowel movements but are unable to wait to reach a bathroom.
  • Other people don’t feel the sensation of a pending bowel movement and have a complete lack of bowel control.

Types & Symptoms

Most adults who experience fecal incontinence do so only during an occasional bout of diarrhea.

  • Some people have recurring or chronic fecal incontinence.
    • Urge incontinence: inability to resist urge to defecate.
    • Passive incontinence: unawareness of need to pass stool.
  • Fecal incontinence may be accompanied by other bowel problems, such as:
    • Diarrhea
    • Constipation
    • Gas and bloating

Diagnosis & Medications

DIAGNOSIS

  • Physician may do/request:
    • History & Physical Exam
  • Other additional tests such as:
    • Stool culture
    • Barium enema (X-ray of the large intestine, including the colon and rectum)
    • Blood tests
    • Electromyography (to test the function of muscles and related nerves)
    • Ultrasound
    • X-ray

 

RECOMMENDED MEDICATIONS

  • Treatment depends on the cause.
  • Options include:
    • Diet modification – increase fiber intake and avoid diarrhea-causing food.
    • Medications
      • For diarrhea: antidiarrheal medications such as loperamide, codeine, or diphenoxylate/atropine (Lomotil).
      • For constipation: fiber supplement.
    • Bowel Retraining.
    • Kegel Exercises – strengthen pelvic floor muscles.
    • Biofeedback – using sensors to develop mental control over bodily functions.
    • Surgery – for severe conditions.
      • Sphincteroplasty: A defective or scarred portion of the sphincter is removed, and the healthy part of the muscle is tightened.
      • Gracilis muscle transplant: The gracilis muscle is transferred from the thigh and placed around the sphincter muscles to add strength and support.
      • Artificial sphincter: An artificial sphincter is a silicone ring that is implanted in the anus. You manually deflate the artificial sphincter to allow for defecation and inflate it to close the anus, which prevents the leakage of feces.
      • Colostomy: Some people who have severe bowel incontinence choose to undergo surgery for a colostomy. During a colostomy surgery, your surgeon redirects the end of the large intestine to pass through the abdominal wall. A disposable bag is attached to the stoma, which is the portion of the intestine that is visible on the outside of the abdomen. After the surgery is complete, stools no longer pass through the anus but instead empty from the stoma into a disposable bag.

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