Fecal Incontinence

Fecal incontinence or bowel incontinence is the inability to control bowel movements. An embarrassing and often underreported condition, fecal incontinence causes stool to leak from the rectum without warning. The symptoms can range from occasional seepage of stool when passing gas to loss of control of full bowel movements. The most common cause of bowel incontinence is damage to the muscles around the anus (anal sphincters).

Conditions that raise the risk for fecal incontinence include:

Board certified colon and rectal surgeons at Brigham and Women’s Hospital (BWH) offer the most advanced and effective approaches for patients with fecal incontinence including both surgical and non-surgical options. Learn more about fecal incontinence.

 

Fecal Incontinence Topics

Diagnosis of Fecal Incontinence

Colon and rectal surgeons at BWH use many diagnostic methods to evaluate fecal incontinence, including:

  • Physical examination and digital rectal examination (DRE)
  • Stool sample
  • Blood test to look for infection
  • Rectal ultrasound
  • CT scan
  • Barium enema
  • Colonoscopy
  • Sigmoidoscopy
  • Colorectal transit study
  • Anorectal function tests. A pressure-measuring tube is placed inside the rectum to measure how well the muscles that control bowel movements are working.
    • Anorectal manometry
    • Anal electromyography
    • MRI of anal sphincter muscles
    • Balloon expulsion test

 

Treatment for Fecal Incontinence

Surgical Treatment

In some cases, you may need surgery to repair damage to the muscles or nerves that are causing bowel dysfunction. Colon and rectal surgeons at BWH offer a range of procedures for treating fecal incontinence:

  • Sacral nerve stimulation is a minimally invasive technique that stimulates nerve roots for improved sphincter function.
  • Sphincteroplasty repairs the muscles of a weakened anal sphincter by stitching them more tightly together.
  • Colostomy

Non-Surgical Treatment

Fecal incontinence can often be treated through dietary and lifestyle changes. Treatment may include:

  • Dietary changes: increasing fiber and fluids
  • Anti-diarrheal medication
  • Laxatives: if constipation is causing incontinence
  • Medications to decrease bowel motion
  • Biofeedback
  • Bowel training
  • Kegel exercises
  • Injectables
What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have fecal incontinence and if surgery is needed. Careful monitoring and the involvement of an experienced colon and rectal surgeon are important to the successful outcome for patients with colorectal conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in fecal incontinence surgery. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues who have extensive experience in diagnosing and treating fecal incontinence. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

Resources

Go to our health library to learn more about fecal incontinence.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.

Access a complete directory of patient and family services.

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