Fecal incontinence is an inability to control one's bowels, so gas and bowel movements are passed accidentally.
Obstetric damage is the most common cause of bowel incontinence in women. During crowning of the baby's head, the opening of the vagina can tear into the anal sphincter muscle. The nerves supplying the anal muscles may also be injured when they are stretched or pressed upon during a long delivery. While some injuries may be recognized immediately following childbirth, many others may go unnoticed and not become a problem until later in life. In these situations, past childbirth may not be recognized as the cause of incontinence.
Anal operations or injury to the tissue surrounding the anal region similarly can damage the anal muscles and affect bowel control.
Infections around the anal area may destroy muscle tissue leading to incontinence.
As people age, they experience loss of strength in the anal muscles and those of the pelvic floor.
Chronic diarrhea may cause leakage as it is hard for even a normal sphincter to hold back liquid stools.
What tests will be done to figure out your problem?
Your surgeon will above all provide an environment that is comfortable and where you feel relaxed.
He will take a thorough history of your previous obstetric/medical and surgical issues. An initial discussion of the problem with your physician will help establish the degree of control difficulty and its impact on your lifestyle. Many clues to the origin of incontinence may be found in patient histories. For example, a woman’s history of past childbirths is very important. Multiple pregnancies, large weight babies, forceps deliveries, or episiotomies may contribute to muscle or nerve injury at the time of childbirth. In some cases, medical illnesses and medications play a role in problems with control.
An exam of the anal region and pelvic muscles will then be performed. It may readily identify an obvious injury to the anal muscles. If you are having chronic diarrhea, he may do a colonoscopy and biopsies.
Once he figures out what is the cause of your problem, he will go on to discuss treatment options. Usually he will start with very simple remedies such as medications, diet changes and Kegel's exercises and then move on in steps to biofeedback and then to surgical or the very modern nerve stimulation/modulation techniques which have been shown in many cases to be quite effective in giving you back your dignity and social life.
In the worst case scenario, a colostomy may be prescribed as a temporary or permanent solution.
Some of my most grateful patients are those I have cured of bowel incontinence.