What happens during a doctor's physical exam for fecal incontinence?

Anthony L. Komaroff, MD
Internal Medicine
During a physical examination for fecal incontinence (unintended passage of stool), your clinician will check your reflexes, walking gait, and senses for signs of general neurological disease or damage. He or she will also examine your abdomen for signs of bowel problems. The main difference in an evaluation for fecal incontinence is that the rectal exam is more thorough than usual.

First, the clinician looks inside the anus for any skin damage or scarring from previous injuries or medical procedures. The shape of your anus -- whether open or closed, perfectly round or asymmetrical, intact or cracked -- is noted. Using a Q-tip or pinprick, the doctor touches various points around your anus to see if it puckers up -- a normal "winking" reflex.

Next, the doctor inserts a gloved finger into your rectum for the digital rectal exam (DRE) to feel for the presence of hemorrhoids, growths, tears, protrusions, or scars. You may be asked to squeeze your muscles around the doctor's finger or to bear down as if you were straining to have a bowel movement. The doctor may be able to feel whether the puborectalis muscle in your pelvic floor -- which forms a sling around the rectum -- is working to keep the colon and rectum at the proper angle. If you feel any pain during the exam, tell the physician.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.