Bowel incontinence
April 18, 2016 | by Laura Gladstone MD

Fecal, or bowel, incontinence is a difficult condition to live with—or admit to. Because of the considerable embarrassment from losing bowel control, a patient’s symptoms are often worse than they are at first willing to share with anyone.

What is fecal incontinence?

Fecal incontinence—sometimes referred to as the other incontinence—is a common condition, however, and estimated to impact more than 18 million people in the United States.

Fecal incontinence is most often seen in women after their childbearing years when they reach their 50s, 60, or 70s, but can also affect younger women and men. Common causes include injury during childbirth, injury during surgery, and conditions related to rectal prolapse.

Symptoms of Fecal Incontinence

  • unable to resist the urge to defecate
  • diarrhea
  • constipation
  • gas
  • bloating

What are the treatment options for fecal incontinence?

Treatment was once limited to a difficult sphincter repair or a life-altering colostomy that required surgery to reattach the large intestine to an opening in the abdomen (stoma) to transport waste.

Fortunately, patients now have an alternative: a simple outpatient surgery called sacral neuromodulation that can greatly reduce or eliminate symptoms.

A device called the InterStim System for bladder and bowel control was developed more than 20 years ago. More than 175,000 patients have received it worldwide and it has proven long-term, clinical effectiveness, with reported success rates of up to 80 percent. It is a minor, one- to two-hour outpatient surgery with minimal downtime and a quick recovery.

How does the InterStim System work?

The device looks much like a pacemaker and works in a similar way, providing an alternative that is simple to live with and maintenance free. It is implanted into the skin of the upper buttock and uses mild electrical pulses to stimulate the sacrum nerves to the pelvic floor, lower urinary tract, colon, and anal sphincters to improve function. Batter powered, it needs replacing every 10 years.

Another benefit of the device is that patients are able to give it a trial run before the device is implanted permanently. The surgeon implants just the lead for one to two weeks to see if symptoms improve, and if the patient is happy with the results, the procedure is scheduled.

After the trial period, 85 percent of my patients see significant improvement and choose to get the device, which is covered by most insurance companies. After surgery, these are some of the happiest patients I’ve seen in my practice.

When to See a Doctor

Talk with your primary care doctor if you have any symptoms of fecal incontinence. If symptoms are mild, your doctor may recommend changes in diet, antidiarrheal medications or other medications, or physical therapy to strengthen the pelvic floor muscles. If you have weekly episodes of fecal incontinence, or suffer poor quality of life as a result of the condition, talk with your doctor about seeing a colorectal specialist to discuss options to greatly improve your quality of life.

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Written By: Laura Gladstone MD