Fecal Incontinence

Fecal Incontinence

This is defined as the involuntary loss of stool. The incidence of FI is more common than previously thought and is generally thought to affect about 1 in 12 adults. FI is not a normal part of aging and is a reason to seek care as this becomes a major quality of life issue with time.

There are different causes of FI such as inflammatory/ absorptive disease in the intestines, medication side effect , neurologic problems such as diabetes or dementia, cancer, spinal cord injury, and anal sphincter damage usually due to childbirth.

Your clinician will take a full medical history, ask about stool consistency, bowel diary, treatments tried , and possibly a pelvic exam.

Treatments vary depending on the cause but typically start with dietary changes. Bulking agents like psyllium and methylcellulose are recommended. Fiber supplements can be helpful as well. Taking anti-diarrhea medications like loperamide 2mg a day or bismuth subsalicylate additionally reduce FI episodes. Physical therapy with biofeedback through our pelvic floor program is encouraged and oftentimes very beneficial. There is a vaginal insert called the Eclipse that is similar to a pessary for helping women with FI not felt to be due to irritable bowel syndrome. This device is fitted in the clinic with instructions given regarding care, removal and replacement. The Eclipse is FDA approved and decreases FI episodes by 50%.

Sacral nerve stimulation is a great advanced same-day surgical treatment option for patients with FI not felt to be caused by radiation or an inflammatory bowel condition. The most common and most studied such device is InterStim made by Medtronic. This FDA approved device has an approximately 90% success rate. Learn more about InterStim here.

Please know that FI is common. Most importantly, please do not be embarrassed to bring up this important issue. Good options exist to remedy this problem.

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