digestive disorders
Fecal Incontinence
Treatment of Fecal Incontinence
Measures to regulate bowel movements Sphincter exercises and sometimes biofeedback Sometimes a surgical procedure The first step in correcting fecal incontinence is to try to establish a regular pattern of bowel movements that produces well-formed stool. Dietary changes, including adequate fluid intake and the addition of a small amount of fiber, often help. A suppository or enema may also be used to help establish a regular pattern of bowel movements. If such changes do not help, a drug that slows bowel movements, such asloperamide, and a low-fiber diet may reduce the frequency of defecation. Exercising the anal muscles (sphincters) by squeezing and releasing them increases their tone and strength. Using a technique called Biofeedback , a person can retrain the sphincters and increase the sensitivity of the rectum to the presence of stool. About 70% of well-motivated people benefit from biofeedback. If fecal incontinence persists, surgery may help—for instance, when the cause is an injury to the anus or an anatomic defect in the anus. As a last resort, a colostomy (the surgical creation of an opening between the large intestine and the abdominal wall—see figure Understanding Colostomy ) may be done. The anus is sewn shut, and stool is diverted into a removable plastic bag attached to the opening in the abdominal wall. 