Diagnosing Fecal Incontinence at Cleveland Clinic
Many things can cause fecal incontinence (sometimes called accidental bowel leakage) — nerve damage, weak anal muscles, other health conditions (like rectal prolapse or inflammatory bowel disease, also called IBD), changes to your diet and even just getting older. In order to find out what’s going on, your providers will do a physical exam and a rectal exam.
You may also have a few other tests to help confirm a diagnosis. For these tests, your provider may:
- Insert a short, thin tube into your anus and rectum to see how tight your anal sphincter muscles are (anal manometry).
- Take pictures of your anal sphincter muscles using a small probe inserted in your anus and rectum (endoluminal ultrasound or anal ultrasound).
- Check how well the pudendal nerves that regulate your bowels are working.
- See if nerve damage is causing your anal sphincters not to work right (anal electromyography, or EMG).
- Examine the end of your colon for inflammation, tumors or scar tissue (flexible sigmoidoscopy or proctosigmoidoscopy).
- Take an X-ray video to see how well your rectum holds and releases stool (protography or defecography).
- Take pictures of your pelvic organs (magnetic resonance imaging, or MRI).
Meet Our Fecal Incontinence Team
Our expert team of healthcare providers will work together to diagnose and treat your fecal incontinence and help you find ways to manage it. Your team may include:
0 Providers Who Treat Fecal Incontinence
Locations
Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and London.
Treating Fecal Incontinence at Cleveland Clinic
Sometimes changing what you eat, strengthening your pelvic muscles or taking medications may be all that’s needed to get your bowels back on track. Other times, you may need surgery to fix damaged sphincter muscles or treat other conditions that are causing your fecal incontinence. Your provider may recommend a combination of therapies, too.
Dietary changes
Diarrhea and soft stool (poop) can make fecal incontinence worse. Our digestive tract specialists and dietitians can suggest foods and drinks you might want to avoid and others to include that will thicken your stool and reduce the chance of having an accident.
Bowel training
Our pelvic floor physical therapists can help you strengthen your sphincter muscles by creating an exercise routine using Kegels and other exercises that focus on your pelvic organs. Developing a bathroom routine or using a daily enema to create more manageable bowel movements may also help. Don’t use an enema without checking with your providers first.
Medications
Our specialists can prescribe medications and fiber supplements to firm up your stool and decrease how many bowel movements you have. They may also recommend topical creams to soothe irritated anal skin. It’s important not to use over-the-counter (OTC) medications without checking with your providers first.
Surgery
Sometimes surgery might be necessary to treat very specific causes that lead to fecal incontinence, like repairing damaged sphincter muscles. Our colorectal surgeons will use the least invasive procedures for treating your condition. They might recommend:
- Sphincteroplasty: In this procedure, your surgeon overlaps and tightens your sphincter muscles to create a tighter anal opening.
- Sacral nerve stimulation: This surgery involves implanting thin, flexible wires under your skin near your tailbone. The wires send electrical impulses to stimulate your sacral nerves and improve how your anal sphincter muscles work.
- Pelvic organ prolapse repair: If you have internal or external prolapse of tissue, then repairing the prolapse may improve continence. This surgery is minimally invasive and can involve abdominal surgery or perineal surgery (through the vagina or anus).
- Colostomy: This surgery brings your colon to the surface of your skin through an opening in your abdomen. Stool is collected in a special pouch attached to the opening.
Taking the Next Step
When your life revolves around making it to the bathroom in time — or not getting there fast enough — it can wear you down. But fecal incontinence doesn’t have to rule your life. Our Cleveland Clinic digestive health specialists can help find ways to treat and manage this frustrating and unsettling problem. And we listen to your concerns with understanding and compassion. We’re here to help you move on with confidence and relief.
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