Fecal Incontinence

What is fecal incontinence?

Fecal incontinence is a disabling condition where patients have the inability to control their bowel movements and consequently have accidents.  The condition may cause significant embarrassment and patients may suffer from low self-esteem, isolation and reduced quality of life.  Fecal incontinence may affect patients of all ages, but is greater in older adults and nursing home residents.  Often times, treatment is delayed due to embarrassment and social stigma.

What are the causes of fecal incontinence?

Numerous factors contribute to fecal incontinence and often the cause is multi-factorial.  The major contributing factors to fecal incontinence include abnormal muscular function or pelvic floor function, diarrhea, or other issues including immobility, drug reactions, or are psychogenic in nature.  The anal sphincteric muscle may be weakened secondary to damage from obstetric injury, surgery, trauma, or nerve damage or disease.  In addition, other disorders leading to pelvic floor dysfunction, such as aging, radiation, bowel diseases may also contribute to fecal incontinence.  Changes in stool consistency such as diarrhea, physical immobility and diminished cognitive function may also lead patients to have stool incontinence.

What are the treatment options for fecal incontinence?

At UCLA Urology our goal of treating patients with fecal incontinence is to restore continence and improve their quality of life.  Treatment options for fecal incontinence depend on the severity and the cause of the fecal incontinence. 

Some treatment options include conservative measures, including medical management or surgery with a procedure called anal sphincteroplasty or sacral nerve stimulation.

For our patients with mild fecal incontinence, conservative measures that can be tried include:

   Dietary Measures

• Avoidance of foods that may aggravate symptoms
• Reducing caffeine consumption, especially after meals, which may help reduce postprandial stool urgency and diarrhea
• Fiber supplementation that may help in bulking stool and reducing diarrhea

   Lifestyle Changes

• Scheduled bowel movements
• Decrease physical activity after meals to avoid increasing colonic motility. 

   Biofeedback

• Also known as neuromuscular training through UCLA Santa Monica has helped to improve symptoms of fecal incontinence.

UCLA has had success in treating patients with sacral nerve stimulation (SNS) in recent years for the treatment of fecal incontinence.  It has been shown to improve fecal incontinent episodes and is thought that SNS helps by improving rectal sensitivity, compliance, or sphincteric tone.

Surgery: Anal sphincter repair or anal sphincteroplasty may also be performed in select cases where there is laxity in the sphincter from obstetric related trauma.