Bowel incontinence or fecal incontinence ranges from an occasional accidental loss of gas to a complete loss of bowel control when leakage of solid stool occurs because you cannot control it. Fecal incontinence can be caused by childbirth, aging, and other factors common to women. It can be an embarrassing condition but we encourage you to talk to your doctor if you are concerned. Treatments are available, and the sooner you are evaluated, the sooner you may find some relief from your symptoms.

Evaluation for fecal incontinence

A complex system of nerves and muscles is involved in bowel elimination. Careful evaluation helps us determine the most effective treatment.

Manometry

For patients with bowel leakage, it may be important to determine the resting and “squeeze” pressure in your rectum and anal canal. A very small flexible tube is used in your rectum to “map” the pressure zones. 

Nerve Studies

If we are concerned that the nerves (including the pudendal nerve) to your pelvic muscles are not working well, specialized nerve studies may be done. We are one of very few places in the United States that does these tests.

Treatment for fecal incontinence

Commonly, we help patients manage fecal incontinence some diet modifications and exercises that improve bowel functioning. In some cases, your loss of control may be due to actual damage of your anal sphincter muscle that occurred at the time of a vaginal delivery. If you experienced a known tear to this muscle at childbirth, you may need surgery to repair the muscle. Treatments include:

Improving symptoms with diet and medications

Often, we can help patients improve symptoms with some modifications to what you eat and drink and possibly a medical prescription.

Physical therapy to improve bowel functioning

If your fecal incontinence is caused by muscle damage, we can work with you to develop a program of exercises to help you restore muscle strength through your pelvic floor and rectum. We use some sophisticated tools to help you get started in retraining muscles without pain. Our physical therapist can help you with exercises to do ongoing and on your own.

Meet the Urogynecology Care Team at OHSU

Surgery for fecal incontinence

In cases where muscle or nerve damage is more severe, or if your fecal incontinence is caused by an underlying problem (such as rectal prolapse or sphincter damage caused by childbirth) we might recommend treatment through surgery. Surgery should be considered when it is the most likely treatment to eliminate fecal incontinence as well as improve your quality of life.