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Weekend doctor: Ladies, let's talk about incontinence

By Jodi Bollenbacher, Certified Physician's Assistant
Blanchard Valley Obstetrics & Gynecology

Women often avoid discussing accidental bowel leakage, also known as fecal incontinence. The subject often seems taboo. Women may think they are the only ones suffering with it and become too embarrassed to talk about it.

As many as one in five adult women suffer from loss of bowel control. Fecal incontinence has been identified as the inciting reason prompting nursing home placement in nearly 50 percent of cases. Women with bowel control problems may leak gas, liquid or solid stool. They may experience a strong or urgent need to have a bowel movement, stool spotting on underwear or pads, diarrhea or constipation.

Accidental bowel leakage can occur if there are problems with the muscles and nerves in the rectum and pelvis. The most common cause of accidental bowel leakage in females is childbirth. During childbirth, the muscles and tissues of the rectum may be stretched or torn or your anal sphincter can be injured.

Other causes can be hemorrhoids that prolapse, certain medications that affect stool consistency, certain illnesses (such as diabetes, multiple sclerosis or stroke) that can damage the nerves to the rectum, problems with the gastrointestinal tract (inflammatory bowel disease, irritable bowel syndrome, or cancer of the rectum), or surgery/radiation therapy to the pelvic area.

If you are experiencing symptoms of fecal incontinence, your health care provider can help. Physicians perform an extensive medical history and exam. Some testing may be necessary such as anoscopy/proctoscopy, anorectal manometry, defecography, nerve tests or ultrasound.

There are several ways that accidental bowel leakage can be treated. The type of treatment that you have depends on the cause of the problem and how severe it is. You may be referred to other health care providers who specialize in treating accidental bowel leakage. Treatment can include lifestyle changes, biofeedback, medications, sacral nerve stimulation, injections and surgery.

Sacral nerve stimulation (InterStim) can be used when the nerves that control the bowels are not working correctly. In this treatment, a device is implanted under the skin, usually right above the buttocks. A thin wire is placed near the sacral nerves (near the tailbone), which control the colon, rectum and anal sphincter. The device sends a mild electrical signal along the wire to these nerves that restores the normal function of the bowels. Studies show that more than 80 percent of patients achieve more than 50 percent reduction in incontinent episodes per week.

Women who suffer from fecal incontinence are not alone. Speak with your provider about treatment options today.