How is fecal incontinence treated?
Depending on the cause of fecal incontinence, treatment can include one or more of these approaches: dietary changes, bowel training (biofeedback), medications, or surgery.
Medical treatment options:
- Dietary tips: The goal of dietary changes is to avoid foods that may cause loose stools, including: caffeine, alcohol, some fruit juices, prunes, beans, cabbage family vegetables, spicy foods, dairy products, cured or smoked meats and artificial sweeteners. Other foods help thicken the stool, which may help fecal control. These foods include bananas, apple sauce, peanut butter, pasta, potatoes and cheese.
- Bowel training: There are two types of bowel training. The goal of the first type is to develop a "going-to-the-bathroom" pattern. By setting up a routine, patients can gain greater control over their bowel movements.
Taking a daily enema at consistent times will help control stool removal and decrease episodes of fecal incontinence. Do not use an enema without checking with your doctor first.
The goal of the second type of bowel training is to learn certain exercises that can strengthen the muscles around the anus. A trained therapist will teach you how to locate the correct muscles and perform the exercises. This process is called biofeedback.
- Medications: Medications that are usually prescribed include anti-diarrheal drugs and fiber supplements. These medications decrease movement of the stool through the intestine and firm up the stool. Do not use over-the-counter medications without checking with your doctor first.
- Skin protection: Since fecal leakage leads to anal skin irritation, moisture–barrier creams -- such as those used for baby's diaper rash -- are used to protect the skin. These products can be used indefinitely. As needed, adult diapers are another consideration. Finally, loose clothing and cotton underwear can help provide comfort. Do not use over-the-counter incontinence medications without checking with your doctor first.
- , or overlapping sphincter repair, sews damaged anal sphincter muscles back together (see below left). The anal sphincter muscle is overlapped and stitches are used to secure the muscle on both sides. Overlapping and tightening the sphincter muscle results in a tighter anal opening.
- ACE procedure is occasionally appropriate for patients with fecal incontinence. In this procedure, the surgeon creates a small pathway from the skin on the abdomen to the bowel. A small tube is inserted through which a daily enema/washout is given to clean out the stool.
- Artificial bowel sphincter involves implanting an artificial device (prosthesis) around the anus. This device is designed to mimic the normal anal muscle.
- Sacral nerve stimulation. Sacral nerve stimulation therapy uses a small device (a neurotransmitter) that is implanted under the skin in the upper buttock area. The device sends mild electrical impulses through a lead that is positioned close to a nerve located in the lower back (the sacral nerve), which influences the bladder, the sphincter, and the pelvic floor muscles.
- Colostomy. In this operation, an opening is made in the abdomen, through which the colon is brought to the surface of the skin. Stool is collected in a special pouch attached to the abdomen around the opening. This procedure is usually considered when all other treatment options have failed.