In diagnosing fecal incontinence, the doctor will interview about your medical history and your condition. Aside from visually examining your anus, the doctor may conduct other tests to pinpoint the leading cause. These tests include:
- Digital rectal exam.The doctor inspects for abnormalities in the rectal area and evaluates the strength of the sphincter muscles by inserting a gloved and lubricated finger into the rectum.
- Balloon expulsion test. A balloon filled with water is inserted into the rectum, and the patient is asked to expel it. If it takes longer than 3 minutes, it may be a sign of a defecation disorder.
- Anal manometry.A test performed to evaluate the tightness of the anal sphincter and the functionality of the rectum. It is inserting a narrow tube with a small balloon on its tip into the anus and rectum. The balloon may be expanded during the test.
- Anorectal ultrasonography.A narrow instrument that captures video and images is inserted into the anus and rectum. This will aid in the evaluation of the sphincter.
- This assesses how much stool the rectum can hold and how well the body expels stool by producing x-ray video images as the patient defecates.
The doctor may prescribe medications for diarrhea or constipation in treating fecal incontinence, depending on the cause. The doctor may also recommend some dietary changes and exercise to improve the stool’s consistency and restore muscle strength.
Some therapies may be considered, such as:
- Biofeedback or simple exercise that can improve anal muscle strength
- Bowel training
- Injection of bulking agents to thicken the walls of the anus
- Sacral nerve stimulation to normalize the sensation and strength of the sphincter muscles
In some cases, surgery will be required, such as for those with sphincter damage. This includes procedures aimed to repair or undergo total replacement depending on the severity of the sphincter damage.