BOWEL INCONTINENCE

• Unable to control passage of gas or stools
• May range from limited soiling of underwear to complete lack of bowel control
• May be accompanied by:
  • Gas and bloating
  • Diarrhea
  • Constipation

DIAGNOSIS

Physician may do/request:

• History & Physical Exam. Anal sphincter muscle strength assessment.
• Stool testing. May identify an infection or other cause.
• Endoscopy. A tube with a camera on its tip is inserted into the anus which identifies any possible problems in the anal canal or colon.
• Anorectal manometry. Measurement of the strength of the sphincter muscle via a pressure monitor which is inserted into the anus and rectum.

Endosonography. An ultrasound probe is inserted into the anus which produces images that can help recognize problems in the anal and rectal walls.

Nerve tests. Measure the responsiveness of the nerves controlling the sphincter muscles and detect nerve damage.

MRI defecography. Provide information about the muscles and supporting structures in the anus, rectum, and pelvis.

RECOMMENDED MEDICATIONS

Medicines that may reduce bowel movement:

• Imodium
• Lomotil
• Hyoscyamine

Methylcellulose. May aid in making stool more solid and easier to control.

Exercises. Regular contraction of the the muscles used to control urinary flow (Kegel exercises) to build strength in the pelvic muscles which may reduce bowel incontinence.

Bowel training. Regular scheduling of bowel movements daily.

Provides feedback as a person does exercises to improve bowel control via A sensor is placed inside the anus and on the abdominal wall.

Surgery may be recommended for people whose bowel incontinence is not helped by noninvasive treatments. The types of surgery include:

• Sphincter surgery
• Sacral nerve stimulator
• Sphincter cuff device
• Colostomy

Other non-surgical procedures:

Radiofrequency anal sphincter remodeling. Creates a mild injury to the sphincter muscles, which become thicker as they heal.

Injectable biomaterials. Materials such as silicone, collagen, or dextranomer/hyaluronic acid can be injected into the anal sphincter to boost its thickness and function.