Fecal Incontinence

Old man with fecal incontinence

Fecal incontinence can be an extremely embarrassing condition.  There are serious psychosocial implications to the condition and there can be severe consequences to a person’s quality of life.

This condition is also known as bowel incontinence or soiling.  It is often called a “silent affliction” due to the stigma surrounding the condition.  Those suffering from bowel incontinence rarely openly admit that it is happening and often try to hide the issue.

It is important as a caregiver or healthcare professional working with older adults to inquire whether fecal accidents are happening or not.  Also, note that urinary incontinence is a often a precursor to bowel incontinence.

There are many potentially contributing factors to fecal incontinence thus making this a difficult condition to treat.

Bowel incontinence happens due changes in the regular physiology/anatomy of the anorectal canal.   This leads to a disruption is the structure and behavior of the anus and rectum.

The potential causes/factors include:

  • changes in consistency of the stool
  • alteration in the movement of fecal contents to the rectum
  • irregular capacity of the rectum
  • changes in the ability of the rectum to regulate it’s pressure and act as a reservoir
  • reduced sensitivity of the anorectal canal
  • improper functioning of the anal sphincter
  • malfunctioning of the pelvic floor

As you can see this is a multifactorial condition.  Very rarely is this health issue caused by only one of these factors. This makes assessing and treating the condition relatively difficult.

Advice and education, supplementation with dietary fiber, biofeedback, pelvic floor exercises and sphincteroplasty are potential treatment modalities for bowel incontinence.

A 2009 study titled “Randomized Controlled Trial Shows Biofeedback to be Superior to Pelvic Floor Exercises for Fecal Incontinence” published in Diseases of the Colon & Rectum found the following:

“Three months after training 76% of patients treated with biofeedback vs. 41% patients treated with pelvic floor exercises reported adequate relief.  At 12-month follow-up, biofeedback patients continued to show significantly greater reduction in Fecal Incontinence Severity Index scores and more patients continued to report adequate relief.

This investigation provides definitive support for the efficacy of biofeedbackBiofeedback training resulted in greater reductions in fecal incontinence severity and days with fecal incontinenceBiofeedback was also more effective than pelvic floor exercises alone in producing adequate relief of fecal incontinence symptoms in patients for whom conservative medical management had failed.”

It would appear that biofeedback is a good, non-invasive treatment option for individual’s with bowel incontinence.

You may also wish to learn about urinary incontinence.