See your doctor if you have bowel incontinence. Tests to determine the cause for incontinence can be completed during an outpatient appointment and are not painful.
Once these tests have confirmed the cause of your incontinence, your doctor can make specific recommendations for treatment, many of which do not require surgery.
No matter how serious the problem seems, incontinence is a condition that can be significantly helped and, in most cases, cured.
How Is Bowel Incontinence Diagnosed?
Endosonography, also called rectal ultrasound, makes it possible to view the anal sphincter muscles and precisely identify abnormalities.
Ultrasound can be used to locate the exact position of a tear in a muscle, even before bowel incontinence becomes a problem.
Other procedures to diagnose bowel incontinence that may be used include:
Flexible sigmoidoscopy. By using a thin, flexible lighted tube called an endoscope, your doctor can examine the lining of the final third of the lower digestive tract.
Manometry. This test measures the pressure and strength of the anal muscles and can determine if they are too weak to function properly.
Nerve studies. These tests check for nerve damage to determine if the nerves that communicate with the sphincter muscles are working properly.
MRI. Magnetic resonance imaging can help identify areas of weakness in the sphincter muscles.
How Is Bowel Incontinence Treated?
Once the underlying cause of bowel incontinence has been identified, most people with this condition can be cured or the condition can be significantly improved. However, the method of treatment depends on the cause of the incontinence.
Sometimes simple changes in diet or eliminating certain medications can be effective in helping patients regain bowel control. More frequently, treatment involves a combination of medication, biofeedback, and exercise.
Medication. Sometimes taking medications to change the consistency of the stool can provide relief, since a person can usually control stool better when it is firm rather than loose or liquid. Over-the-counter anti-diarrheal medications may include
Imodium, and prescription medications may include
Lomotil.
Biofeedback. Biofeedback training for bowel incontinence involves putting a pressure probe in the anus or a sensing electrode on the skin. These devices are attached to a visual or sound display to tell the patient when the proper anal muscles are being used. Biofeedback helps a patient improve the strength and coordination of the anal muscles that help control bowel movements, as well as heightens the sensation related to the rectum filling with stool.
Exercise. Muscle-strengthening exercises (called Kegel exercises or pelvic floor exercises) can be very helpful in treating bowel incontinence. To do Kegel exercises contract the muscles of the anus, buttocks, and pelvis and then hold as hard as possible for a slow count of five and then relax. Imagine you are trying to stop the flow of stool and urine or trying not to pass gas. A series of 30 of these exercises should be done three times daily. In a few weeks, the pelvic floor muscles will be stronger and often the incontinence improves or resolves.
Surgery. Patients who continue to experience bowel incontinence despite other treatments may require surgery to regain control. Surgery may especially be needed for patients who have experienced anal muscle injuries (as can occur during childbirth).
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