Fecal Incontinence (bowel leakage)
Accidental bowel leakage (fecal incontinence) is a common problem affecting between 1.4%-18% of healthy adults, and the most common cause of admission into nursing facilities. Data suggests that nearly 20% of women >45 years old have accidental bowel leakage at least once a year, and about 9.5% have at least one episode per month. These statistics are important because this is a problem that so many struggle with but are either too embarrassed to talk about it with their physician, or have no idea that there are solutions!
What is ABL exactly? We define it as uncontrolled passage of stool or gas over at least one month’s duration, in a person who previously had normal continence. Sometimes patients will have leakage only with diarrhea or gas but are fine with solid stool.
What causes it? Obstetric trauma (vaginal deliveries) with sphincter injury, previous anorectal surgery (hemorrhoidectomy, sphincterotomy, fistula surgery), neurologic disorders, GI disorders, history of pelvic radiation can all contribute to the development of accidental bowel leakage. It is important to note that although women tend to be affected more, men can also suffer from fecal incontinence.
What do we do about it? A thorough history and physical exam is key to determining the cause and severity of incontinence. It is important to determine if incontinence is from sphincter muscle damage, a nerve issue or if it is simply a dietary/bowel habit issue. In many cases, adding fiber to diet is enough to stop the leakage. Bulking stool can make sensation easier and allow time to reach the toilet before an accident occurs. Physical therapy (pelvic floor therapy) is a useful modality that is usually used prior to surgical intervention. Pelvic floor therapy can help improve sensation, strength and coordination.
In some cases, surgery is the best option. Sphincter repair and stimulation of the sacral nerves are both techniques used by colon and rectal surgeons to treat ABL.
At OC Colorectal clinic, we employ the most advanced techniques to treat this problem. Call and make an appointment today! You can also go to www.fascrs.org to look for a board-certified colon and rectal surgeon in your area.
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