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Bowel incontinence (also known as fecal incontinence) is the inability to control your bowel movements, causing stool to leak unexpectedly. Bowel incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control. Bowel incontinence may be due to a weakened anal sphincter associated with aging or to damage to the nerves and muscles of the rectum and anus from giving birth.
There are several tests physicians use to diagnose the reasons for loss of bowel control.
Anal manometry is a commonly used test in which a physician inserts a narrow, flexible tube into your anus and rectum. Once the tube is in place, a small balloon at the tip of the tube may be inflated. This test measures the strength of the anal sphincter. It also measures the sensitivity and function of the rectum.
To evaluate the structure of the anal sphincter, a physician inserts a narrow, wand-like instrument into the anus and rectum. This instrument emits sound waves that bounce off the walls of the rectum and anus, producing video images of these internal structures.
A defecography is an X-ray test that shows the rectum and anal canal as they change during a bowel movement. The patient is asked to have a bowel movement on a commode while a radiologist takes X-rays of the patient’s pelvis. Although awkward, this test provides valuable information about the patient’s pelvic floor muscles and rectum.
Before recommending a surgical procedure, the Griffin Hospital Center for Bladder & Bowel Control will tests therapies including medications, dietary changes, and physical therapy.
The staff of the Center for Bladder & Bowel Control may recommend medications to treat bowel incontinence, including anti-diarrheal drugs, laxatives, stool softeners and other drugs that decrease the spontaneous motion of your bowel or medications that decrease the water content of your stool.
For urinary incontinence, the staff may recommend medications including anticholinergics to calm an overactive bladder, topical estrogen to help tone and rejuvenate tissues in the urethra and vaginal areas, and antidepressants to treat urge and stress incontinence.
Your diet may be the cause of bladder or bowel incontinence. If chronic constipation is to blame for bowel incontinence, your physician may recommend drinking plenty of fluids and eating fiber-rich foods. If diarrhea is contributing to the problem, high-fiber foods can add to add bulk to your stools, making them less watery.
To treat bladder incontinence, you may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption and losing weight can also eliminate the problem.
If bowel incontinence is due to a lack of anal sphincter control or decreased awareness of the urge to defecate, you may benefit from a bowel-training program and exercise therapies. Bladder incontinence may be resolved through pelvic floor muscle exercises, also known as Kegel exercises, to strengthen your urinary sphincter and the muscles that help control urination.
Some of the more successful surgical procedures for treating bowel and bladder incontinence include:
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