Fecal incontinence is described as the inability to control bowel movements, causing stool or gas to leak without voluntary control. Many causes are related to the presence of fecal incontinence, idiopathic and also nerve or muscular damage after child delivery and pelvic surgery. This is indeed a taboo subject, but many possible treatments are described, so don´t be ashamed, and seek for professional opinion. Correct diagnosis is mandatory in order to reach the correct treatment, either medical or surgical. Endoanal Ultrasound ( EAU) is a very useful tool in order to identify the normal anatomy of the anal canal, and the integrity of the sphincter muscles. Depending on the cause of the incontinence, different treatments can be use:
-Conservative measures, such as medicines to slow down intestinal motility ( such as loperamide) and bulk laxatives when necessary.
– Posterior Tibial Nerve Stimulation. ( PTNS) This minimally invasive treatment consists on the electrical stimulation of the posterior tibial nerve (at the level of the ankle). This can be achieved on several ambulatory sessions.
– Bulking Agents: By this therapy we try to augment the thickness of the anal sphincter by injecting bulky agents in the anal canal.
– Sphincteroplasty: When a permanent damage at the level of the external sphincter is done, it needs to be surgically repaired.