Fecal incontinence, also called bowel leakage, may feel stressful and embarrassing to talk about, but you don’t have to deal with it alone. At Penn Medicine, our experienced team provides expert, compassionate care. Our comprehensive services to manage fecal incontinence help you get back to the activities you enjoy.
What Is Fecal Incontinence?
Fecal incontinence, or bowel incontinence, is loss of bowel control and involves accidentally passing bowel movements. Also called accidental bowel leakage, the condition can range from small leaks to complete accidents that happen without warning.
At Penn Medicine, our urogynecologists specialize in female pelvic medicine and reconstructive surgery. With our nurse practitioner, our team offers compassionate, personalized care to bring you relief.
Types and Symptoms of Fecal Incontinence
The two main types of fecal incontinence have slightly different symptoms:
- Urge: You feel a sudden, strong need to have a bowel movement but cannot reach a toilet in time.
- Passive: You don’t feel the urge to have a bowel movement and experience bowel leakage without realizing it.
Causes of Fecal Incontinence
Fecal incontinence has many causes and risk factors, including:
- Childbirth by vaginal delivery, which can damage muscles or nerves in the rectum and anus
- Conditions that affect the intestines, rectum or anus, such as pelvic organ prolapse, severe hemorrhoids or inflammatory bowel disease
- Long-term use of laxatives (medication to loosen stool and ease constipation)
- Nerve or muscle damage caused by an injury, a tumor or radiation treatment
- Neurologic injuries or diseases, which affect the brain, spinal cord and nerves, such as dementia, multiple sclerosis, Parkinson’s disease and spina bifida
- Problems with bowel consistency, including diarrhea, chronic constipation or impacted stool (dry, hard stool)
- Surgery to treat conditions in the rectum, anus or other pelvic organs
Diagnosing Fecal Incontinence
Fecal incontinence might not be easy to talk about — we understand, and we’re here to help. Our team provides a comfortable environment to meet for your evaluation.
Our urogynecologists begin by asking you about your medical history and symptoms. We do a physical exam along with internal pelvic and rectal exams to check these internal organs.
To confirm a diagnosis, you may need one or more tests, such as:
- Anorectal manometry: We check how well the muscles and nerves in your anus and rectum are working, using a thin, flexible tube.
- Endoanal ultrasound: This imaging test uses sound waves to create images inside the body. We use a narrow probe to take images of the anal sphincters (muscles surrounding the end of the rectum) to assess their shape and structure.
- Lab tests: Blood, stool and urine tests can show signs of infection and diseases that might be contributing to fecal incontinence.
- Magnetic resonance imaging (MRI): An MRI uses radio waves and a large magnet to create images inside the body. We use MRI to check the structure of your anus and rectum and look for any problems in nearby pelvic organs.
Fecal Incontinence Treatment at Penn Medicine
Our urogynecologists and nurse practitioner have years of focused experience treating women with fecal incontinence and other pelvic floor disorders. Meet our urogynecology team.
Your treatment options for fecal incontinence depend on what’s causing it. Our team provides an accurate diagnosis so you can receive the right treatments to help you feel better. You may need more than one treatment, and we begin with the least invasive options that improve your symptoms.
Nonsurgical treatments for fecal incontinence
Nonsurgical treatments can help you prevent accidents and manage symptoms, often through lifestyle changes and self-care techniques. We provide counseling and prescriptions for treatments including:
- Bowel training: Establishing specific times to have a bowel movement can help you regain control.
- Healthy eating plan: You can eat more fiber to relieve constipation and avoid foods that lead to diarrhea. We also recommend drinking plenty of healthy fluids such as water.
- Medications: Anti-diarrheal drugs, stool softeners and laxatives can help with stool consistency and prevent accidents. We can prescribe medications to treat digestive causes such as irritable bowel syndrome and inflammatory bowel disease.
- Pelvic floor exercises with biofeedback: Our specialized physical therapists teach you exercises to help strengthen your pelvic floor muscles to prevent bowel leakage. Biofeedback helps you sense when a bowel movement is coming and how to contract muscles to prevent accidents. Biofeedback is a painless technique that uses special sensors and a screen to show muscle activity. Find out more about pelvic floor outpatient physical rehabilitation at Penn Medicine.
Surgery for fecal incontinence
Our skilled urogynecologists perform surgery to treat fecal incontinence if nonsurgical treatments aren’t working. We have years of training and experience in the latest procedures, including:
- Neuromodulation device: Our urogynecologists implant a small stimulator device under the skin in your buttock. It sends mild electrical pulses to the nerves that control bowel function to help calm muscles in the lower large intestine.
- Sphincteroplasty: We can repair a torn anal sphincter that was damaged or weakened during childbirth or other injury.
- Surgery to treat pelvic organ prolapse: If the cause of fecal incontinence is a pelvic organ that has shifted out of place, our urogynecologists can restore pelvic floor support with surgery. Learn more about pelvic organ prolapse.
- Fecal transplant: Penn Medicine is the first program in the country exploring fecal microbial transplantation to treat fecal incontinence in a clinical trial.
Clinical Trials for Fecal Incontinence Treatments
Our urogynecologists research leading-edge treatments for all types of pelvic floor disorders. Our Urogynecology program is one of a few research sites in the Pelvic Floor Disorders Network (PFDN), a research and clinical care network sponsored by the National Institutes of Health.
Participating in clinical trials gives our eligible patients access to promising new diagnostic methods, nonsurgical treatments and surgical techniques before they’re widely available. Learn more about our Urogynecology care.
Request an Appointment
Call 800-789-7366 or complete our online form.