Fecal Incontinence: Talk to Your Doctor Today

fecal incontinenceFecal Incontinence (FI) is the accidental or involuntary loss of liquid or solid stool from the rectum. The two most important things to know about FI are:

  1. It is not a normal part of aging. And
  2. You are not alone.

Fecal incontinence affects nearly 18 million adults in the United States and has a profound impact on one’s quality of life. Still, many women are hesitant to talk to their doctors about this condition because they are embarrassed or think that there is nothing that can be done about it.

What Causes Fecal Incontinence?

There are many different factors within the body that have to all work together to keep us continent. These include intact mental function, normal volume and consistency of stool, and intact muscles, nerves, and reflexes within our colon and anal canal. A problem with any of these factors can lead to fecal incontinence.

Some examples of factors that can cause fecal incontinence include:

  • Neurologic conditions such as dementia, stroke, or multiple sclerosis
  • Diarrhea (from infection, irritable bowel, lactose intolerance, colitis, etc.)
  • Obstetric injury or trauma
  • Previous surgeries (hemorrhoids, fistulas)
  • Anatomic issues (tumors, hemorrhoids, fistula, rectal prolapse)
  • Medications
  • Radiation

Receiving Treatment for Fecal Incontinence:

The physicians of the Female Pelvic Medicine and Reconstructive Surgery division of Emory Clinic’s Department of Gynecology and Obstetrics are here to help you deal with this devastating condition. Your care with us often involves a team approach in which we collaborate with our colleagues from colorectal surgery and gastroenterology (GI), as well as a fantastic group of physical therapists.

What Can I Expect from My Visit?

During your visit you will have an in-depth conversation with your doctor, where we will review your medical history, including other medical conditions, surgeries, medications, etc. You will also undergo a full physical exam including a rectal and vaginal exam. Your doctor may order additional tests depending on your situation, including:

  • Endoanal ultrasound: This is done to see if your anal sphincter may have been torn or injured
  • Pelvic MRI or Defecography: This looks for possible anatomic causes and demonstrates how you eliminate stool during a bowel movement
  • Anal Manometry: This tests the reflexes, sensation and the function of your internal and external anal sphincter
  • Endoscopy: You may be asked to undergo a colonoscopy or another similar type of imaging procedure to rule out inflammatory conditions or cancers

Is There Hope? Treatment Options for Fecal Incontinence

Yes, there is hope. Treatment will be tailored to your specific cause of fecal incontinence as well as the severity of your symptoms. Our treatment approach will take into account your other medical conditions as well as your personal limitations or constraints. A large part of the treatment plan requires your participation, as it involves behavioral approaches and lifestyle changes. Some of these include:

  • Diet and fluid management
  • Bowel retraining/toileting techniques
  • Weight loss
  • Fiber supplements
  • Medications
  • Pelvic floor muscle exercises
  • Biofeedback

If these more conservative therapies fail, other more advanced treatment options your doctor may discuss with you include:

  • Anal injections with bulking agents
  • Sacral nerve stimulation (Interstim)
  • Posterior Tibial Nerve Stimulation (PTNS)
  • Anal sphincter repair
  • Colostomy

About Kristie Greene, MD

Kristie Greene, MDKristie Greene, MD, is an Assistant Professor in the Department of Gynecology and Obstetrics at Emory University School of Medicine. She is a member of the Female Pelvic Medicine and Reconstructive Surgery division, also known as urogynecology. Dr. Greene sees patients at the Emory Clinic at 1365 Clifton Road, in Building A on the 4th floor. She completed medical school at Loyola University’s Stritch School of Medicine and went on to complete both her residency and her fellowship in Female Pelvic Medicine and Reconstructive Surgery at the University of South Florida. To make an appointment with Dr. Greene or any of our urogynecologists, please call 404-778-3401.

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