What Can Cause Fecal Incontinence?
Fecal incontinence (FI) is a highly embarrassing and potentially life-altering condition in which you can no longer control your bowels fully. Or at all. Instead of privately and comfortably evacuating your bowels in the bathroom, you leak fecal matter in various quantities.
Approximately 8% of women and men in the United States suffer from FI. However, sometimes children and teens develop it, too.
When you have FI, your first question is probably how do you stop it? The second is, why did you develop it in the first place?
At Colon and Rectal Surgeons of Greater Hartford, our team understands how frustrating and humiliating FI can be. We help you understand why you developed this condition and custom design a solution to help you manage it.
Why did you develop FI? It might be due to several reasons.
You battle chronic diarrhea or constipation
Changes in your bowel habits can send signals to your rectal muscles that alter their function. Chronic diarrhea is one of the most common triggers for FI in people who aren’t institutionalized. Loose, watery stools build up quickly and are difficult to hold in.
Conversely, constipation can trigger Fi because the hard stools cause your rectal muscles to stretch and weaken. Straining to pass stool may also damage the nerves that alert you that it’s time to defecate. If you have irritable bowel syndrome with diarrhea, constipation, or both, you’re at increased risk for FI.
Your pelvic floor is dysfunctional
Another cause of FI is pelvic floor dysfunction. The pelvic floor is a sling of muscle tissue that supports your genitourinary organs. When it becomes stretched, weakened, or loose, your organs no longer get the support they need. Urinary incontinence is a common first effect, but FI may soon follow. You may have pelvic floor dysfunction due to:
- Vaginal birth delivery
- Trauma to the pelvic floor
- Pelvic surgery
- Aging
- Sitting for long periods
- Obesity
- Sedentary lifestyle
Pelvic floor dysfunction can lead to rectal prolapse. Your rectum sinks into your anus. That prevents your anal muscles from closing completely, allowing leakage to occur. It may also contribute to a condition known as rectocele in women, in which the rectum pushes into a thinned vaginal wall, making it difficult to pass stool.
Nerve damage
A traumatic brain injury (TBI) or spinal cord trauma can cause FI. Anything that damages the nerves that control your rectum and anus, in fact, can interfere with your ability to sense the need for a bowel movement or to evacuate at will.
Many things can damage the nerves in your rectum and anus, including surgery and trauma. However, even straining to pass stools when you’re chronically constipated can eventually damage these key nerves. That’s why it’s important to pay attention to your bowel habits and get help as soon as something changes or if you feel uncomfortable.
Neurologic disease
Neurologic conditions that affect the way your brain processes information and communicates with the nerves throughout your body can cause FI. Conditions and diseases that are associated with FI include:
- Alzheimer’s disease
- Other forms of dementia
- Parkinson’s disease
- Stroke
- Multiple sclerosis
- Type 2 diabetes
In type 2 diabetes, uncontrolled blood sugar damages blood vessels, which eventually leads to nerve damage and neuropathy. You may no longer be able to sense the urge to defecate.
Hemorrhoids
Untreated, even a relatively simple and common condition such as hemorrhoids can lead to FI. When your hemorrhoids are large enough, they may prevent your anus from closing completely. This allows stool and mucus to leak from your anus.
Treatment depends on cause and severity
Once we know why you have FI, we can then approach your main question: ‘How can we stop it?’ Depending on your cause and severity, our team customizes a treatment plan. You may benefit from first-line therapies such as:
- Adding more fiber to your diet
- Drinking more water
- Getting more exercise
- Bowel training
- Biofeedback
- Medications
If conservative treatment fails to improve your fecal incontinence, the team could suggest other treatments, such as sacral nerve stimulation (SNM) with the Axonics SNM System™, an implanted device. Tens of thousands of patients with FI or urinary incontinence find relief with the SNM system for years at a time.
Other specialized treatments include an injection that decreases the size of your anus, so that it can better withhold stool. Or, you may require surgery to repair and strengthen damaged muscles.
If you have FI due to pelvic floor dysfunction or other reasons, call us at 860-242-8591. You can also schedule your appointment online at our Bloomfield, South Windsor, or Plainville, Connecticut, clinics.