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How is bowel incontinence treated?

Bowel incontinence, also referred to as fecal incontinence, is a condition that affects millions of Americans. It comes in several forms, from “uncontrollable” gas to the dreaded fear of “accidents” of liquid or solid stool.

These are disabling symptoms that keep individuals from living normal lives. Unfortunately, most patients do not speak to their family or personal physicians about this problem, and they suffer in silence for months to years.

There are ways to diagnose and treat bowel incontinence that gives patients hope! The first challenge is to talk to your physician about the problem. You aren’t the first to suffer from this situation, and you won’t be the last so don’t be embarrassed to speak up. A basic review of your symptoms along with your medical and surgical history and an examination is a great place to start.

The answer to why one may be having bowel incontinence may be solved simply by identifying your degree of incontinence. A mild case of incontinence may be solved by increasing the amount of fiber in the diet (25-30 grams /day), increasing the amount of water intake (64 ounces) and daily exercise (including Kegel exercises).

More severe cases of fecal incontinence may require testing of the anal sphincter mechanism, called a Pelvic Floor Panel, to determine the best course of action. Remember, the testing is done in order to educate you and the physician on the issues that may be present. Not to fear, the tests include minimally invasive catheters and devices to help quantify the sphincter strength and tone. In addition, the pelvic nerves and anatomy can be evaluated with a simple exam and ultrasound probe about the size of a Chap Stick tube. All of these tests can be done in the Colon and Rectal Specialists office with minimal discomfort and without anesthesia—you can even drive yourself to and from the clinic.

After testing, your physician can recommend the best course of action. And many patients find they do not need surgery for their bowel incontinence.

Treatments for bowel incontinence will depend on the cause and severity of the condition, and may include medication, dietary changes, biofeedback or surgery. Often more than one modality is used to treat the contidion.

Dietary changes. Eating more fiber or less fiber and avoiding caffeine, may help. Keeping a food diary can help pin down what foods trigger an episode of incontinence. Other foods that can cause diarrhea and incontinence are alcohol, dairy products, cured or smoked meat, spicy foods, fruit, fatty foods and dietary sweeteners such as sorbitol, xylitol, mannitol and fructose. Eating smaller meals more frequently, or drinking before or after meals but not while eating may also be suggested.

Medications. Depending on the particular problem, medication to help control diarrhea, or conversely, bulk laxatives to help develop more regular bowel movements may help, depending on the particular problem.

Biofeedback. Biofeedback techniques can be taught to help control and strengthen anal muscles. A computer measures muscle contraction while the patient performs muscle exercises for the pelvic floor (Kegel exercises) with the goal of strengthening rectal muscles and improving sensation. These exercises are evaluated by computer and offer feedback.

Surgery. Surgery is an option for individuals for whom dietary changes and biofeedback do not help, or for those with an injury to the anal sphincter, anal canal or pelvic floor. Surgery can repair injury to the sphincter mechanism, or help constrict the sphincter using the patient's tissue or a device. In addition, minimally invasive surgery may be possible for patients with rectal prolapse, which allows for less postoperative pain, less medication and more rapid healing when compared with traditional open surgical techniques.

Colostomy. This procedure may be necessary for people with very severe bowel incontinence, for whom other treatments do not help. In this procedure, which may be temporary or permanent, the colon is surgically disconnected and one end brought through an opening made in the abdomen, called a stoma, through which stool exits the body and is collected in a pouch attached to the abdomen.

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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.