What tests are used to diagnose fecal incontinence?

You will be evaluated by a gastroenterologist and/or a colorectal surgeon who is trained to help you. Your doctor will ask you questions about your condition, and then perform a physical exam and a rectal exam. Do not feel embarrassed to talk to your doctor. He or she understands that you may not be comfortable talking about this problem.

The following tests may be done to diagnose fecal incontinence:

  • Anal manometry – This test studies the strength of the anal sphincter muscles. A short, thin tube, inserted up into the anus and rectum, is used to measure the sphincter tightness.
  • Endoluminal ultrasound or anal ultrasound – This test helps evaluate the shape and structure of the anal sphincter muscles and surrounding tissue. In this test, a small probe is inserted up into the anus and rectum to take images of the sphincters.
  • Pudendal nerve terminal motor latency test – This test measures the function of the pudendal nerves, which are involved in bowel control.
  • Anal electromyography (EMG) – This test determines if nerve damage is the reason why the anal sphincters are not working properly. It also examines the coordination between the rectum and anal muscles.
  • Flexible sigmoidoscopy or proctosigmoidoscopy – This test evaluates the end of the large bowel or colon, looking for any abnormalities -- such as inflammation, tumor or scar tissue -- that may cause fecal incontinence. To perform this test, a thin tube with a camera attached at the end is inserted into the rectum up to the sigmoid colon. This allows the lining of the bowel to be viewed.
  • Proctography (also called defecography) – This test is done in the radiology department. In this test, an X-ray video is taken that shows how well the rectum is functioning. The video shows how much stool the rectum can hold, how well the rectum holds the stool, and how well the rectum releases the stool. To make the X-ray video for this test, a small amount of liquid barium is released into colon and rectum (through a tube inserted up into the rectum).
  • Magnetic resonance imaging (MRI) – This test is done in the radiology department. It is sometimes used to evaluate the pelvic organs.

Last reviewed by a Cleveland Clinic medical professional on 05/13/2016.


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