Faecal incontinence is loss of gas, solid or liquid stool without the knowledge of the individual. It is commoner in women due to birth injuries. Women typically complain saying that they are not able to hold their gas or that they loose stool whenever they do active work like bending, lifting objects or coughing etc.

Sometimes motion may seep out and wet their panties even at rest. It is a very embarrassing situation and is a serious threat on a woman’s quality of life. Birth injuries are the principal cause of faecal incontinence in women. Women who experience complete tear of their perineal area are more prone for FI. Also upto 30% of women who delivered using forceps can experience FI later in life.

Causes of Faecal Incontinence:

  1. Injuries caused during child birth
  2. Severe strain on the pelvis area for prolonged time
  3. Medications
  4. Lifting heavy weights, especially in incorrect way – this damages pelvic muscles.
  5. Age, radiation therapy or any surgery that weakens back muscles.
  6. Disease of bowels – Coeliac disease, Crohn’s disease
  7. Nerve disorders
  8. Diarrhoea or Constipation.

Symptoms of Faecal Incontinence:

While it is sounds obvious that the primary symptom will be the person noticing ejection of stool or liquid or sometimes even blood involuntarily, there are other symptoms too that may be noticed.

  1. Bowel mishaps that happens regularly
  2. Change in normal bowel movements and habits. (Change in frequency and the time when you visit toilet)
  3. Though you have emptied your bowels, you still feel that it’s not complete.
  4. Age, radiation therapy or any surgery that weakens back muscles.
  5. Unexplainable weight loss – note that this happens in several cases, but you need to have one /more other symptom along with this to classify the problem as faecal incontinence.

When you have these symptoms or at least some of these, you must immediately visit a urogynecologist (an expert is always better than a cheap doctor near you) and let him/her take a through physical examination if and when required.  Explain to him/her the complete symptoms and the problems that you are facing. Talking to the doctor openly helps him/her analyze the condition and suggest appropriate treatment. You may be advised to get some tests done to zero-in on the root cause of the problem.

Medical Tests to determine the cause of Faecal Incontinence:

While it is sounds obvious that the primary symptom will be the person noticing ejection of stool or liquid or sometimes even blood involuntarily, there are other symptoms too that may be noticed.

  1. Digital Rectal Exam: In this physical examination, your urologist/urogynecologist will lubricate his/her gloved finger and inserts into your rectum to check the strength of sphincter muscles.
  2. Balloon expulsion test: A balloon is inserted into your rectum. It is then filled with water. You will then be asked to go to toilet and expel that balloon just the way you eject your stool. If you take longer than 3 minutes to expel, you are likely having a problem with defecation.
  3. Anal Manometry: A flexible, narrow tube is inserted into your anus with a balloon. Then the balloon is inflated. How easy is it to inflate the balloon tells the doctor, how strong your rectal muscles are.
  4. Proctography: X-ray video images are shot while you are emptying your bowels on a specially designed toilet. This test measures the amount of stool your rectum can hold and how well it can empty it.
  5. Colonoscopy: A flexible tube is inserted into the rectum and the entire colon is examined.
  6. MRI – Magnetic Resonance Imaging: This tells if the muscles are in good condition and also provides images during excretion.

Treatment options for Faecal Incontinence:

While it is sounds obvious that the primary symptom will be the person noticing ejection of stool or liquid or sometimes even blood involuntarily, there are other symptoms too that may be noticed.

  1. Medications – Anti diarrheal drugs may be prescribed or you may be advised to use laxatives in case of chronic constipation.
  2. Changes in Diet may be advised that will affect how easily you pass stools. (High fiber foods may be advised).
  3. Anal Manometry: A flexible, narrow tube is inserted into your anus with a balloon. Then the balloon is inflated. How easy is it to inflate the balloon tells the doctor, how strong your rectal muscles are.
  4. Surgical Treatment – as a last resort or depending on the severity of the condition, conventional or laser surgery may be used to treat faecal incontinence.