Bowel incontinence is the inability to control bowel movements. It's a common problem, especially among older adults. Accidental bowel leakage is usually not a serious medical problem. But it can seriously interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment. Fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.
Damage to muscles and nerves may occur directly at the time of vaginal childbirth or after anal or rectal surgery. Neurologic diseases such as stroke, multiple sclerosis, spinal cord injury, and spina bifida can be potential causes of fecal incontinence. Complications of diabetes can also cause peripheral nerve damage leading to incontinence.
Patients with inflammatory bowel disease like Crohn's disease, ulcerative colitis and irritable bowel disease may develop fecal incontinence. Stool seepage is different than fecal incontinence. Minor staining can occur in people who have hemorrhoids, rectal fistula, rectal prolapse and poor hygiene. Other causes include chronic diarrhea, parasite infections, and laxative abuse. Paradoxical diarrhea or overflow incontinence may occur in a person who has chronic constipation. In paradoxical diarrhea, stool fills the rectum, hardens and becomes impacted. Liquid stool leaks around the fecal mass, imitating incontinence.
Common causes of fecal incontinence include muscle weakness or damage or nerve damage, Loss of Stretch in the Rectum, Childbirth by Vaginal Delivery, Hemorrhoids and Rectal Prolapse, Rectocele, Inactivity. The muscle or nerve damage may be associated with aging or with giving birth.Whatever the cause, fecal incontinence can be embarrassing. But don't shy away from talking to your doctor. The physical exam will likely include a rectal examination to exclude an obvious cause, such as a mass or fecal impaction, and to gauge the function of the anal muscles. Based on the history and physical exam findings, doctor will determine what tests are needed for further evaluation. These tests include Manometry, Rectal ultrasound (endosonography), Flexible sigmoidoscopy, MRI, Nerve studies
Sometimes simple changes in diet or eliminating certain medications can be effective in helping patients regain bowel control. More frequently, treatment involves a combination of medication, biofeedback, and exercise, surgery, minimally invasive procedures.