State-of-the-Art Techniques to Diagnose and Treat Fecal Incontinence
Loyola Medicine takes an integrated, multidisciplinary approach to the diagnosis and treatment of fecal incontinence. Millions of Americans experience fecal incontinence and many suffer in silence, keeping incontinence to themselves and going years without receiving proper treatment. Loyola’s team of highly experienced specialists will evaluate your symptoms, provide you with the correct diagnosis and develop an individualized treatment plan. Loyola offers a wide variety of options to ease symptoms or eliminate incontinence, which can improve your quality of life and help you enjoy a more functional life again.
Why Choose Loyola for Fecal Incontinence?
Loyola provides truly integrated clinical care for fecal incontinence, bringing together specialists in gastroenterology, colorectal surgery, reconstructive pelvic surgery and others to provide men and women with advanced care in a compassionate environment. As part of an academic medical center, Loyola’s expert clinicians perform and teach the latest surgical techniques and medical treatments in numerous locations across the Chicago area. In addition, our nurses have earned Magnet status, which means they have been recognized for delivering the highest level of care.
Loyola’s clinicians and resident scientists are engaged in clinical research on fecal incontinence, which allows us to offer our patients the latest innovative techniques and medications. If your situation does not improve with medical treatment, our widely acclaimed surgical team has had great success in treating incontinence symptoms.
If your incontinence is related to a chronic pelvic floor condition, our chronic pelvic pain program is one of few in the United States. Loyola was one of the first medical centers in the nation to create a chronic pelvic pain program, which was founded by an all-female group of doctors, surgeons and advanced practice nurses, some of whom have been providing women’s healthcare for more than 30 years.
What It Is
What is Fecal Incontinence?
Fecal or bowel incontinence is the loss of control over bowel movements. Some people may lose only a small amount of gas or liquid stool, while others are unable to control an entire movement of solid stool. Although fecal incontinence occurs in both men and women, it may be more common in females; about one in 10 women older than 40 has some form of fecal incontinence.
Fecal incontinence can be temporary or chronic and ongoing. Normal control of bowel movements depends on proper functioning of the colon and rectum, the muscles surrounding the anus (anal sphincter muscles), the brain and the nervous system, as well as the amount and consistency of stool produced. Fecal incontinence may occur with other bowel problems, including:
There are many causes of fecal incontinence, including:
- Anorectal surgery for another condition, such as a fistula or hemorrhoids
- Back or spinal surgery or trauma
- Conditions with chronic constipation or diarrhea, such as Crohn’s disease or ulcerative colitis, may lead to fecal impaction, which over time can stretch and weaken the rectal muscles
- Muscle or nerve damage injury to the anal sphincter, which can occur when a women delivers a child
- Nerve damage, including spinal cord injury
- Pelvic radiation
- Poor nutrition
- Rectal prolapse, in which the rectum collapses through the anus
- Spinal cord damage
- Systemic diseases that affect the whole body, such as diabetes and multiple sclerosis
- Use of certain medications, including some antibiotics
How is Fecal Incontinence Diagnosed?
In order to diagnose the cause of your fecal incontinence, your Loyola doctor will take a detailed medical and family history and conduct a thorough rectal exam. Based on this, your doctor may request additional testing, which may include:
- Anorectal manometry — This test measures the pressure and strength of the anal muscles in patients with constipation or fecal incontinence.
- Balloon expulsion test — A medical balloon is inserted into the rectum and filled with water. Then the patient is asked to expel the balloon. The time that this takes will help your doctor diagnose the cause of your fecal incontinence.
- Colonoscopy — Using a thin, flexible, lighted tube, your doctor can view your colon, take tissue samples and detect ulcers, colon polyps, tumors and areas of inflammation or bleeding. Learn more about colonoscopy.
- Defecography — This study is used to evaluate prolapse symptoms associated with bowel function.
- Endoscopic ultrasound (EUS) — EUS can be used to evaluate and diagnose gastrointestinal conditions and allows your doctor to view the anal sphincter muscles and check for muscle tears and other abnormalities.
- Nerve study — This will provide information about the electrical activity of the nerves in the pelvic floor.
- Pelvic floor MRI (magnetic resonance imaging) — Your doctor may request an MRI of your pelvic floor in order to evaluate function of the muscles, organs and support of the pelvic floor.
- Stool test — Fecal matter is collected and analyzed for bacteria or any abnormalities that may cause diarrhea.
How is Fecal Incontinence Treated?
Loyola’s gastroenterologists, colorectal surgeons and pelvic floor specialists specialize in the diagnosis, treatment and management of fecal incontinence. Loyola’s clinicians have received specialized training to diagnose complex conditions and provide the most advanced treatment options. Treatments generally include behavioral changes, medical devices, medications and surgery. Your doctor will discuss all appropriate options in detail with you and answer any questions before beginning treatment.
Non-surgical Treatment Options
Your doctor will first explore conservative, non-surgical treatments to address your condition. These may include:
- Biofeedback therapy — A device is inserted in the anus or placed on the skin to determine whether a patient is using the proper muscles to control defecation. Biofeedback helps patients improve strength and coordination of the anal muscles. Learn more about biofeedback therapy.
- Bowel training — Your doctor will work with you to set up a specific schedule for eliminating stool, such as after a meal, to retrain your body.
- Diet changes — Elimination of certain foods may ease or eliminate symptoms.
- Injections — Botox® injections may be used to relieve fecal incontinence symptoms, building up the tissue mass in the anal sphincter.
- Pelvic floor exercises — Strengthening pelvic floor muscles through Kegel exercises can help ease the symptoms of fecal incontinence. Learn more about pelvic floor physical therapy.
- Medications — Your doctor may prescribe medication to increase the firmness of stool or decrease spontaneous bowel movements. Medications taken for other conditions may cause chronic diarrhea; changing medications or dosage may ease or eliminate this problem.
Surgical Treatment Options
Your doctor will first explore conservative, non-surgical treatments to address your condition. However, if surgery is deemed the best option, Loyola’s surgeons can provide expert care using the most advanced treatment options. Surgical treatment for fecal incontinence may include:
- Anal sphincteroplasty — For patients with torn anal sphincter muscles due to a difficult vaginal delivery or a previous anal surgery, Loyola’s surgeons are skilled in anal sphincteroplasty, which restores muscular function to the anal sphincter by using a muscle from the inner thigh.
- Bulking agent therapy — For patients experiencing fecal or urinary incontinence, this procedure may provide relief by reinforcing the thickness of the muscles in the anus or urethra to prevent leakage.
- Colostomy — For patients who have had a portion of the colon removed due to severe colon and bowel conditions and diseases, a colostomy may be required to facilitate excretion of stool. This is accomplished through an opening in the abdominal wall and the attachment of the colon to an external bag, which is used to collect stool outside the body.
- Prolapse surgery — For patients experiencing organ prolapse, Loyola’s surgeons are skilled in various surgical options to repair the condition. Learn more about organ prolapse.
- Sacral nerve stimulation (neuromodulation) — Your doctor may recommend sacral nerve stimulation for the treatment of urinary incontinence, overactive bladder, fecal incontinence or other pelvic floor disorders. This technique is used to stimulate the nerves that control bladder function and bowel movements through the use of a small device that is implanted under the patient’s skin.
For most forms of fecal incontinence, treatment can lead to dramatic improvement. In addition to the reduction or elimination of your symptoms, many women and men experience an overall improvement in the quality of their lives.
Specialized Care to Diagnose and Treat Fecal Incontinence
Loyola’s specialists provide diagnosis and treatment of fecal incontinence in outstanding, conveniently located facilities. We offer multidisciplinary facilities at the Loyola University Medical Center campus, in addition to outpatient services at other locations.
We offer the following specialized services to provide you with the most comprehensive care:
- Colon and rectal surgery — Our experienced team of colon and rectal surgeons treat a variety of problems with the colon, rectum and anus ranging from cancers to benign conditions, such as hemorrhoids.
- Pelvic floor physical therapy — Loyola’s program works in conjunction with our chronic pelvic pain program, which was one of the first such programs in the United States. Our all-female team utilizes advanced techniques to provide relief for many treatment-resistant conditions. Our team is trained in pelvic health and may use hands-on techniques to release trigger points and re-educate muscles affected by pelvic and nerve pain. Loyola’s physical therapists are skilled in evaluating and treating dysfunction in the joints, muscles, nerves and scar tissue. These treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate.
- Urogynecology and reconstructive pelvic surgery program — Our program was the first of its kind in the greater Chicago area and is still one of few programs in the country that offers a single-site location for the multidisciplinary diagnosis and treatment of pelvic floor dysfunction for women.
Ongoing Research to Improve Future Treatments of Fecal Incontinence
Loyola’s expert clinicians are actively pursuing new research with a focus on patient-centered outcomes. As an academic medical center, Loyola is dedicated to improving future treatments by conducting research on new diagnostics and treatments. Loyola’s patients benefit from research discoveries made here; read about Loyola’s current clinical trials.