Fecal Incontinence
Fecal Incontinence
What is fecal incontinence?
Patients with fecal incontinence have trouble controlling gas or bowel material. It’s a condition that can impact people of all ages for various reasons and is very embarrassing and bothersome. Patients find that fecal incontinence interferes with their ability to work, exercise and enjoy social activities. In older people, this is a frequent reason for placement in a nursing home.
Fecal incontinence increases with age, affecting an estimated 1 out of 13 women younger than 60 and 1 out of 7 women older than 60 years old. While many may think this only affects women, a recent review of 38 studies found that the prevalence of fecal incontinence was roughly equal between men and women (~8 out of 100).
There are different types of anal incontinence, including:
- Flatal incontinence – the inability to control the passage of gas
- Fecal incontinence – the inability to control the passage of liquid or solid stool
- Double incontinence – the inability to control both the passage of stool from the rectum and urine from the urethra (the tube that urine travels through)
- Rectovaginal fistula – when a connection develops between the vagina and rectum, resulting in stool being passed through the vagina
Our Approach
University of Michigan Health physicians provide comprehensive surgical and non-surgical services for people suffering from fecal incontinence and other pelvic floor disorders. We see people of all age ranges, including women who have this condition shortly after childbirth.
Appointment Information
To schedule an appointment or learn more about the Michigan Bowel Control Program, call 734-763-6295 #3.
How is fecal incontinence diagnosed?
Many tests are available to help diagnose the different forms of fecal incontinence. Examination of your rectum and anus may be done to look for hemorrhoids and prior scarring, as well as to assess the strength of your muscles and your ability to squeeze those muscles. For women, a pelvic exam of the vaginal canal is often needed as well as disorders in this area can affect both urinary and fecal incontinence.
In addition, other exams may be performed to accurately diagnose the type and cause of incontinence:
- Defecography – uses X-ray to see what is happening as you have a bowel movement and if there are blockages or pelvic organs pushing into your anus or rectum
- Anal manometry – determines if the muscles of the rectum are strong and functioning properly
- Colonoscopy – in addition to screening for colon cancer, colonoscopy can help detect other bowel problems that could be contributing to incontinence
- Transanal ultrasound – looks at your anal sphincter, which is the muscle that allows you to control your bowel movements
- MRI – looks at the muscles of the pelvic floor, which help control your bowel movements, as well as the nerves in your back, which are important to bowel control
How is fecal incontinence treated?
Treatment options depend on the type of incontinence, the cause and the severity. In some cases, treatment may be as simple as lifestyle and diet modifications. For some, treatment may include physical therapy to strengthen and retrain pelvic and sphincter muscles. Electrical stimulation also can help strengthen your muscles. You may be prescribed one of several medications. There are also a variety of surgeries that may help your particular symptoms.
The Michigan Bowel Control Program (MBCP) is a unique program dedicated to caring for individuals with bowel disorders, including fecal incontinence. To address the complexity of causes of fecal incontinence and the impact it can have on people’s lives, MBCP provides a multidisciplinary consultation service with nurses and physicians from the departments of colorectal surgery, gastroenterology, gynecology, psychiatry, radiology, nursing and physical therapy. Our combined efforts allow for individualized approaches to improve patient care.
How can you care for yourself when you have fecal incontinence?
- Keep a food diary of what you eat. This will help you learn which foods make your incontinence worse.
- Eat small, frequent meals. Large meals may cause diarrhea.
- Avoid constipation:
- Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
- Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
- Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
- Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
- Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
- Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
- Try pelvic floor (Kegel) exercises, which tighten and strengthen the pelvic muscles. (If doing these exercises causes pain, stop doing them and talk with your doctor.) To do Kegel exercises:
- Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine. Your belly, legs, and buttocks shouldn't move.
- Hold the squeeze for 3 seconds, then relax for 5 to 10 seconds.
- Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.
- Repeat the exercise 10 times a session. Do 3 to 8 sessions a day.
- Take care of your mental health, and get support if you need it. Fecal incontinence can affect many aspects of your life, including your mental health. Talk to your doctor if you are feeling sad or anxious and it is not getting better. Support can also come from a counselor, support group, or trusted friend or family member.
Locations
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Women's Clinic | Von Voigtlander Women's Hospital 1540 E Hospital Dr
Floor 9
Ann Arbor, MI 48109-4276Get Directions
Doctors
Mary Fleming Ackenbom, MD
Clinical Associate Professor
Obstetrics & Gynecology, Female Pelvic Medicine & Reconstructive Surg
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