Fecal Incontinence
Restore bowel control with advanced diagnostics and treatments, including nerve stimulation.
Fecal incontinence is the inability to control bowel movements. This condition ranges in degree of severity, affects approximately seven percent of the population, and is more common in women. A variety of treatments for fecal incontinence exist; unfortunately, due to embarrassment or lack of information, many people fail to seek help. Texas Colon & Rectal Specialists strive to provide our patients with leading edge treatment options, including the minimally invasive placement of a sacral nerve stimulator.
Fecal incontinence is caused by a multitude of factors, making it important to determine the cause and severity through history, physical examination and specialized testing called pelvic floor testing. This test may include anal manometry, rectal sensation, pudendal nerve testing and anal ultrasound. Texas Colon & Rectal Specialists utilize this group of minimally invasive tests to determine sensation in the anal canal or rectum, measure the pressures of the anal sphincter muscles, and test for nerve damage. Visit our pelvic floor center to learn more about anal manometry and other diagnostic testing.
Education on lifestyle changes that may reduce bowel accidents, include fiber supplements, suppositories, nutrition recommendations and antidiarrheal medications, if indicated.
Non-invasive management of fecal incontinence can include biofeedback therapy and pelvic floor retraining to strengthen the anal sphincter muscles and improve bowel control.
Originally developed for the treatment of urinary incontinence and urinary frequency, sacral neuromodulation has also been proven to significantly help those suffering from bowel incontinence by gently stimulating the nerves controlling the bowel. The procedure takes place in an outpatient procedure in two phases.
The first phase allows the patient to test the therapy for one-to-two weeks. If significant improvement is documented, the second phase for long-term therapy is scheduled.
To determine if sacral neuromodulation is an effective therapy, a short testing period is required in which a small wire is placed under the skin near the tailbone during an outpatient procedure. The wire is connected to an external trial stimulator (worn temporarily near the lower back or hip) and sends mild electrical pulses to the nerves controlling bowel function. Patients are asked to document daily symptoms to determine if enough improvement is experienced to move forward with the long-term device.
If a patient and physician determine measured improvement, they become a candidate for long-term therapy. During the second outpatient procedure, a small implantable device is placed beneath the skin in the upper part of the buttock. The device mildly stimulates the pelvic nerves that assist in the communication between the brain and those muscles and nerves that control bowel function. This stimulation can be adjusted with the use of a small patient remote control.
The majority of patients suffering from fecal incontinence experience a separation of the anal sphincter muscle caused by child birth or prior surgery. Patients typically remained hospitalized several days after surgery with a recovery of two to four weeks.
The Acticon™ Neosphincter is a device used to treat severe fecal incontinence when less invasive treatments have failed. A small, fluid-filled device is implanted within the body and designed to mimic the natural function of the anal sphincter muscle, controlling bowel movements.
The Secca® procedure is completed on an outpatient basis under sedation. Through the use of an electrode, Secca® delivers controlled radiofrequency energy to the tissues of the anal canal causing gradual improvement in tone, improving bowel control. Patients typically resume normal activity within a few days.
