Bowel Incontinence

What is incontinence?
Incontinence is the inability to control your bowel movements, causing stool (feces) to leak unexpectedly from your rectum. Bowel incontinence symptoms can range from an occasional leakage of stool while passing gas to a complete loss of bowel control. Patients wear pads to absorb the leaked stool or in severe cases have to change their clothing after accidents. Fecal incontinence is a much more common condition, but is under reported due to patients’ embarrassment and reluctance to discuss this unpleasant issue with a physician.

What causes incontinence?
The ability to hold stool requires the normal function to your rectum, anus and nervous system. Also, you have to have the physical and mental capabilities to recognize and appropriately respond to the urge to defecate. There are many causes of incontinence which is much more common in women than men. Damage to the nerves that control the anal sphincter or those that sense stool in the rectum can result in fecal incontinence. Childbirth, constantly straining when having a bowel movement, spinal cord injury and stroke can all cause nerve damage. Disease can also affect these nerves, such as diabetes and multiple sclerosis, and cause damage leading to fecal incontinence.

A broad range of conditions and disorders can cause fecal incontinence, including:

• Constipation
• Obstetric/childbirth injuries
• Diarrhea
• Muscle damage
• Surgery
• Rectal cancer
• Nerve Damage
• Anal Infection
• Loss of muscle strength with age
• Chronic laxative abuse

How is the cause of incontinence determined?
To determine the cause of fecal incontinence, your doctor will ask you questions which are related to your condition- such as when and how often you experience an inability to control your bowels. A visual inspection is performed of your anus and the area lying between your anus and genitals for hemorrhoids, infections and other conditions. A digital exam may also be performed to evaluate the strength of your sphincter muscles and to check any abnormalities of the rectal area. During the exam your physician may ask you to bear down to check whether rectal prolapse or certain other conditions exist.

A number of medical tests can help pinpoint the cause of fecal incontinence. They may include:

• Anal manometry – measures the sensitivity and function of your rectum.
• Anorectal ultrasonography – evaluates the structure of your sphincter.
• Defecography (proctography) -measures how much stool your rectum can hold.
• Anal electromyography- helps reveal signs of nerve damage.
• Sigmoidoscopy- helps detect signs of inflammation, tumors or scars tissue that may cause fecal incontinence.

What can be done to correct the problem?
Many successful treatment options are available to the great relief and surprise of many patients with bowel incontinence. These treatments can usually help restore bowel control or at least substantially reduce the severity of the condition. Depending on the cause of your incontinence, treatment may include dietary changes and/or medications to help control the frequency and consistency of stool, rehabilitation exercises to strengthen the sphincter muscle, and a variety of surgical procedures are available and used in more sever cases.

New Surgical Procedure – SECCA®
A new surgical technology called SECCA has been perfected and used extensively by the physicians of Atlanta Colon and Rectal Surgery, PA. This minimally invasive outpatient procedure causes increased development of collagen and connective tissue to the sphincter muscle which allows for better function. Many of our patients have reported significant improvement in their control with this technique.