Bowel / Fecal Incontinence

Bowel (fecal) Incontinence is the impaired ability to delay the release of gas or stool. Its severity ranges from mild difficulty with gas control to severe loss of control over liquid and formed stools.

Causes:

• Pelvic floor muscle damage: If the muscles that control bowel continence are damaged, fecal/bowel incontinence may result. These muscles include the anal sphincter and the muscles of the pelvic floor.
• Nerve Injury: Injury to the nerves that supply the pelvic floor can cause fecal incontinence.
• Functional: Diarrhea (not being able to make it to the bathroom on time), constipation (rectum gets over filled and leaks), rectal spasms and urgency.

Workup at Austin Urogynecology includes a history of symptoms and physical exam. Testing often times includes endoanal ultrasound (EUAS) and AnoRectal Manometry (ARM). During EAUS, an ultrasound probe is inserted into the anal canal and provides imaging of the internal and external anal sphincters. A defect in either sphincter can be identified. ARM provides information about the pressure and function of the rectum and anal sphincter. The muscles tested during AnoRectal Manometry (ARM) control bowel movements by relaxing and contracting. In addition, ARM detects impaired sensation of rectal filling, which can be a cause of chronic constipation.

Treatment for Bowel (fecal) incontinence can include lifestyle changes, pelvic floor physical therapy, interstim, or anal sphincteroplasty with perineorrhaphy.