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Bowel incontinence

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Overview of bowel incontinence / Fecal incontinence

Bowel incontinence or Fecal incontinence (FI) is a physical condition when a person does not have control over bowel movement leading to unintentional defecation. Such discharge may include flatus, liquid stool, mucus, or solid feces. 


Symptoms of bowel incontinence / Fecal incontinence

Symptoms for bowel incontinence are primarily the lack of control over bowel discharge and may also include other symptoms like diarrhea, constipation, gas and bloating

There is a great social stigma attached to a disease like bowel incontinence and people may feel embarrassed to mention all the symptoms. This at times aggravates the problem and also leads to significant mental trauma for the patient.

Causes of bowel incontinence / Fecal incontinence

Bowel incontinence can be due to a number of factors and is often a result of number of factors coexisting in a person. The most common cause for bowel incontinence is obstetric injury and after effects of anorectal surgery. 

Other causes of bowel incontinence include:

  • Overuse of laxative  
  • Colectomy or bowel surgery
  • Gynecological, prostate, or rectal surgery
  • Injury to the anal muscles due to childbirth (in women)
  • Nerve or muscle damage (from trauma, tumor, or radiation)
  • Severe diarrhea that overwhelms the ability to control passage of stool
  • Rectal prolapse


Risk factors of bowel incontinenc
/ Fecal incontinence

Risk factor for bowel incontinence increases with age. Although the problem can occur to people of any age group, it is more common for middle aged or older adults. The problem is also more common amongst female who are aged 40 and above. It is believed that one reason for higher incidence of the disease amongst females can be linked to complication during childbirth. Risk of bowel incontinence also increases due to nerve damage or people with Alzheimer's disease and dementia

Diagnosis of bowel incontinence / Fecal incontinence

For a doctor diagnosing the problem can be easy if all the symptoms are mentioned. Subsequently a physical examination of the anus will bring greater clarity for the doctor. 

Medical tests: A number of tests are available to diagnose bowel incontinence:

Physical examination – In this case a doctor will insert a lubricated and gloved finger into the rectum in order to gauge the strength of the sphincter muscle. A relatively fast and inexpensive method, it also enables a doctor to check for rectal prolapse.

Balloon expulsion test – In this method a small balloon filled with water is inserted into the rectum. The patient is asked to expel the balloon and the time taken to do this is measured. A time of one minute or longer is generally considered a sign of some problem.

There are plenty of other tests that a doctor can suggest like anal manometry (to measure tightness of anal sphincter), anorectal ultrasonography, proctography, proctosigmoidoscopy, endorectal ultrasoundmm, colonoscopy, anal electromyography and Magnetic resonance imaging (MRI).


Treatment of bowel incontinence / Fecal incontinence

Treatment of bowel incontinence can be varied and depends on the prevailing symptoms. Medications can range from anti-diarrheal drugs to laxatives, if the incontinence is caused by constipation. Doctors may also prescribe a patient to undergo bowel training. A patient is encouraged to tune his body so that he can have greater control on his bowel discharge. 


When medications fail to treat bowel incontinence one may need a surgery to reverse the problem such as rectal prolapse or sphincter damage, Surgery in this case could range from sphincteroplasty (a procedure that repairs a damaged or weakened anal sphincter) to removing hemorrhoids surgically to treating rectal prolapse. If repair is not possible a sphincter replacement surgery maybe needed to correct bowel incontinence. In this surgery a damaged anal sphincter is often replaced with an artificial anal sphincter.

Home Remedies

Home remedies for bowel incontinence includes changes in diet. For someone suffering from diarrhea increasing intake of food with fiber, reducing wholegrain cereals/bread, reduce fruit and vegetables which contain natural laxative compounds, pulses, cabbage and sprouts, reducing spices, reducing artificial sweeteners, reducing alcohol and milk may prove helpful.

In many cases exercises to increase the strength or your rectal muscle and anal sphincter maybe suggested. Kegel exercises are particularly helpful in improving strength of anal sphincter.


Prevention of bowel incontinence / Fecal incontinence

Bowel incontinence can be hard to prevent if it is a cause of trauma to the anal sphincter. However, it is always helpful to reduce the chances of constipation, have a good exercise regime, eat high-fiber foods and drink plenty of fluids. One should also effectively treat diarrhea and avoid straining during bowel discharge when in constipation. 

Written by: Healthplus24 team
Date last updated: July 24, 2013

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