Fecal Incontinence

Woman with incontinence problem with HELP on paper
Exercises to strengthen the muscles of the vagina and pelvic floor muscles.

Fecal incontinence is the inability to control when you release gas or stool. Often this condition can result in fecal leakage and significant disruption to daily life. Experts estimate that over 18 million adults in the United States struggle with fecal incontinence.

Fecal incontinence can be a very difficult, often embarrassing, topic to discuss. However, you can rest assured the Colorectal Division of North Carolina Surgery at UNC REX team helps people manage this condition every day. So, you can feel comfortable discussing fecal incontinence with our professional and experienced team.

Causes of fecal incontinence

Fecal incontinence can be caused by:

  • Chronic (long-term) rectal prolapse
  • Chronic proctitis (irritation of the rectum)
  • Chronic constipation
  • Colorectal or anal cancer
  • Neurological conditions, such as multiple sclerosis
  • Prior pelvic surgery
  • Prior radiation therapy
  • Trauma during pregnancy and childbirth, such as an episiotomy (surgical cut between the vagina and anus)
Symptoms of fecal incontinence
In addition to the inability to control stool or gas, you may experience other symptoms. For example, long-term exposure to moisture and stool may cause the skin in or around your anus to break down. Some people also experience urinary incontinence (inability to control urine flow).
Treatment for fecal incontinence

The first course of treatment for fecal incontinence is typically lifestyle modifications. These modifications may include taking a bulk-forming fiber supplement to help soften your stool and allow your body to more fully empty your bowels. On the other hand, if you experience loose stool, your surgeon may recommend over-the-counter or prescription anti-diarrheal medication. Your surgeon may also recommend pelvic floor physical therapy and biofeedback to help retrain your pelvic floor muscles.

If lifestyle modifications are not enough to control your symptoms, your specialist may recommend surgical options, such as:

  • Sacral nerve stimulator placement. In this surgery, the surgeon places a small transmitter under your skin near the buttocks. The transmitter sends mild electrical pulses through a thin wire near the sacral nerve, which controls the bladder, sphincter and pelvic floor muscles. This procedure helps the bowel and sphincter muscles work together to control your fecal incontinence.
  • Sphincteroplasty. Often used to correct damage caused in childbirth, this procedure repairs weakened or torn anal sphincter muscles so you can better control your bowels.

For both procedures, your surgeon uses sedation so you are asleep and don’t feel pain during the surgery. In addition, we offer these procedures on an outpatient basis, meaning you’ll return home the same day as your surgery.

If severe fecal incontinence does not respond to other treatments, your specialist may recommend an ostomy. During the procedure, your surgeon guides a piece of your colon through an opening in your abdominal wall. Fecal matter will then drain into an ostomy bag or pouch outside your body. An ostomy can greatly improve the quality of life for those with severe fecal incontinence.

Learn more about the procedures and surgeries that our team offers.