Bowel Incontinence
What Is Bowel Incontinence?
Bowel incontinence is a frequent and debilitating condition that may result from many different causes. It is defined as the uncontrolled passage of feces or gas over at least 1 month’s duration, in an individual of at least 4 years of age, who previously had bowel control.
What Causes Bowel Incontinence?
Continence depends on the complex relationships between the anal sphincter and muscles in the pelvic floor. A number of conditions can affect the ability of the rectum and anus to hold stool.
Sphincter muscles can become weaker as you grow older. Muscles or nerves can be damaged during child birth, trauma, or during surgery. Nerve malfunction can also occur in people with diabetes or after a stroke. Other conditions, such as neurological diseases, can also cause bowel incontinence.
How Is The Cause Of Bowel Incontinence Diagnosed?
An initial discussion of your symptoms with your gastroenterologist will help establish the degree of incontinence and its impact on your lifestyle. Patients with a medical history of chronic bowel incontinence are evaluated by providing a detailed patient history including history of childbirth, illnesses, medication or any previous surgeries. Patients are asked to keep a bowel diary, to track when and how often they are experiencing incontinence problems.
A physical examination of the anal region should be performed. It may identify an obvious injury to the anal muscles. In addition, diagnostic testing may be necessary to determine the cause and possible treatments.
What Treatments Are Available?
Fortunately, effective treatments are available, which may improve bowel control. The type of treatment depends on the cause and severity of the condition. More than one treatment may be necessary in some patients.
Initial treatment options include dietary or lifestyle changes; bowel retraining or other kinds of physical therapy or anti-diarrheal medications. More advanced treatment options include surgery or implanting Sacral Neuromodulation.
What Is Sacral Neuromodulation?
For patients who have not responded to more conservative treatments for chronic bowel incontinence, both The American Society of Colon and Rectal Surgeons (ASCRS) and American College of Gastroenterology (ACG) recommend Sacral Neuromodulation (SNM). The procedure has been shown to be an effective treatment for incontinence. It involves inserting a stimulator into the nerves that control the muscles of the anus.
Prior to the implantation of a permanent device, a temporary stimulator evaluation device is placed near the sacral nerves and connected to an external neurostimulator. The system uses mild electrical pulses to stimulate the sacral nerves located near the tailbone. The procedure is minimally invasive and helps determine if Sacral Neuromodulation will reduce troublesome bowel symptoms by at least 50% before a permanent SNM device is implanted.
PA GI’s board-certified gastroenterologists are trained and experienced in conducting Sacral Neuromodulation evaluations.