FECAL INCONTINENCE
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Fecal loss can be a debilitating condition that can result in social isolation. It is thought that up to 15% of people struggle with fecal incontinence. There can be various reasons why a woman can have fecal incontinence, but there are options to improve fecal loss and get you back to living your life.
FECAL/ANAL INCONTINENCE
Did you know that, according to the American College of Gastroenterology, more than 5.5 million people in the U.S. struggle with fecal incontinence? Due to its sensitive nature, fecal incontinence likely isn’t a topic you hear discussed in the open very often. Still, as a common condition among older individuals and women, it is certainly more prevalent than you think. While usually not indicative of a severe medical condition, fecal incontinence can feel embarrassing and may have negative consequences on your social life and self-esteem.
It’s time to stop letting fecal incontinence prevent you from enjoying the activities you love. At Urogynecology NoVa, double board-certified Dr. Maria Canter and her all-woman staff provide a safe and supportive environment where you feel empowered to take back control of your health and your life. Our providers will work with you to evaluate, diagnose and treat your incontinence with treatment plans and minimally-invasive solutions tailored to your specific needs.
WHAT IS FECAL INCONTINENCE?
Fecal incontinence, sometimes referred to as anal or bowel incontinence, refers to the inability to control your flatus (gas) or bowel movements, causing gas or stool to leak involuntarily from your rectum. The condition’s symptoms can range from mild in nature, such as the occasional leak while passing gas, leakage during daily activities and exertion or struggling to make it to the bathroom in time. Or, in more severe cases, bowel control is completely lost.
Bowel control, or continence, relies on the normal function of the rectum, anus and nervous system. There are two groups of muscles in the wall of the rectum and anus that are responsible for holding stool in the rectum: the external anal sphincter and internal anal sphincter. If either of these sphincter muscles experiences injury, trauma or weaken with age, it can result in a loss of bowel control.
Continence also relies on your nerve’s ability to sense the presence of stool in your rectum, as well as the ability to relax and store stool when it is not a convenient time to go to the bathroom. If the nerves supplying the sphincter muscles become damaged from injury or trauma, it can interfere with your ability to sense and hold in stool. Nerve malfunction can also be the result of other medical conditions such as diabetes or the aftermath of a stroke or be caused by excessive straining.
Regardless of the cause, Urogynecology Center NoVa understands the toll that fecal incontinence can take on your everyday life and well-being. That’s why our top priority is to provide women with an array of safe and minimally-invasive treatments that can restore both your continence and your confidence for a more carefree, enjoyable life.
HOW IS FECAL INCONTINENCE DIAGNOSED?
At Urogynecology Center NoVa, fecal incontinence can be diagnosed by evaluating your personal medical history, performing a physical examination to identify any injury to the anal muscles or the use of a bowel movement diary to establish your body’s patterns. For some instances, diagnostic testing may be indicated, which can include a colonoscopy or consultation with your gastroenterologist. There are a number of reasons why a woman may develop fecal incontinence during her lifetime, including:
- Childbirth-related injury: Childbirth is the most common cause of fecal incontinence, resulting from a tear in the anal muscles after vaginal birth. Nerves that control the anal muscles can also sustain injury from childbirth and lead to incontinence. While these injuries are sometimes detected immediately after delivery, they can also go unnoticed for years until they cause problems later in life.
- Age-related loss of muscle strength: Some individuals will gradually lose anal muscle strength as they get older. Often a mild incontinence problem may have existed during their youth but worsens later in life. Trauma to the anal muscles: Prior anal surgery or traumatic injury to the tissues near the anal region can damage anal muscles and lessen the control of bowel movements.
- Neurological diseases: Severe stroke, spinal cord injuries or advanced dementia can result in a lack of control of the anal muscles and contribute to incontinence.
- Medical illnesses or conditions: Anorectal lesions, irritable bowel syndrome (IBS) or inflammatory bowel disease can be related to fecal incontinence symptoms.
After establishing the cause of your fecal incontinence, Dr. Canter will work with you to devise a customized treatment plan that is tailored to your needs and goals for rehabilitation. It’s essential to be patient with the results of your therapies, as it can take some time to observe noticeable improvements to your condition.
TREATMENTS FOR ANAL INCONTINENCE
Depending on the cause of your fecal incontinence and it’s severity, your treatment plan may begin with at-home remedies such as dietary changes and specialized exercises, or progress to more rigorous treatments if conservative measures are ineffective.
Urogynecology Center NoVa offers the following treatment methods for fecal incontinence:
Dietary Changes
Certain foods or beverages can worsen fecal incontinence or cause diarrhea. With dietary changes, a list of foods or drinks known to aggravate symptoms of incontinence will be removed from your diet for some time, then reintroduced to determine their effect on your condition. Foods that can worsen fecal incontinence may include spicy foods, fatty or greasy foods, cured meat or dairy products, especially if you are lactose intolerant. Beverages that contain caffeine or artificial sugar can also act as laxatives and trigger symptoms.
Medications
Specific medications such as Imodium or fiber supplements can result in firmer, bulkier stools and enable you to have more control over your bowels. Firm, solid stools allow your anal muscles to hold back stool more efficiently and prevent unwanted leakage.
Pelvic floor therapy
Pelvic floor therapy involves meeting with a specialist to learn exercises and techniques that are known to improve the strength of the pelvic floor muscles. Pelvic floor physical therapy can be useful for improving stress urinary incontinence, urge urinary incontinence, urinary urgency, urinary frequency and fecal incontinence.
Pelvic floor rehabilitation
Pelvic floor rehabilitation involves the passive stimulation of pelvic floor muscles using noninvasive devices such as BTL’s Emsella, which contracts your pelvic muscles for you. These treatments can help to identify and strengthen the muscles of the pelvic floor responsible for both stress urinary incontinence and fecal incontinence concerns.
- Emsella is an FDA-cleared chair device that uses high-intensity focused electromagnetic (HIFEM) energy to stimulate and contract your pelvic floor muscles without any work on your end. This noninvasive 28-minute treatment is performed twice weekly for three weeks and allows you to remain fully clothed during your treatments. The muscle contractions that occur during an Emsella treatment are the equivalent of doing 11,000 Kegels in one comfortable appointment.
Muscle Strengthening Exercises
In mild cases of fecal incontinence, simple at-home exercises similar to Kegal exercises can be performed to strengthen the anal muscles and help to restore your bowel movement control.
Neuromodulation
Neuromodulation is a technology in which stimulation is sent to the nerves responsible for controlling urinary urgency, urinary frequency, urge-related urinary incontinence, fecal incontinence and urinary retention. There are currently two primary forms of neuromodulation:
- Sacro Neuromodulation – This form of neuromodulation involves placing a small wire attached to a battery placed under the skin. The wire and battery are similar to a pacemaker and are inserted into the hip pocket area. Electrical stimulation is sent from the wire to the area of the nerves that help control bladder and bowel function. You will be provided with a remote that communicates with the battery so that you can control the stimulation, turn it off and on and try various stimulation programs. This is a popular option for patients because the battery only requires replacement every four to six years and doesn’t require many in-office visits once your programs are set.
- Tibial Nerve Stimulation – This form of neuromodulation is external. A thin acupuncture needle is gently inserted into the inside of the ankle. An external battery is then attached to the needle and works to deliver stimulation that gives a fluttering sensation in the foot while the battery is connected. This energy is applied for 30 minutes. Since this option is not implanted, it requires repeat treatments weekly for 12 weeks, and then monthly.
Don’t let fecal incontinence stand in the way of the life you want. Now is the time to explore your treatment options and start living in total confidence. To learn more about fecal incontinence and the solutions we offer, contact the Urogynecology Center NoVa office today at (703) 293-5239 to schedule your in-person consultation.
The information about fecal incontinence was reviewed by Dr. Maria Canter. If you have any questions, please don’t hesitate to contact us using our contact form below.