Gastroenterology and hepatology > Fecal incontinence: treatment options

  • Fecal incontinence is the inability to control the bowels, with unwanted or unplanned loss of stool (feces) or flatulence (wind). The first step is to treat any underlying disorder or problem (e.g. medication, toilet access or lack of activity/exercise) that may be contributing to fecal incontinence or constipation.
  • Check your diet – avoid anything that makes the consistency of your feces looser; increase the amount of natural fiber and avoid artificial fibers and caffeine. In addition, eat smaller meals and drink before or after meals, but not during, to help slow things down.
  • Bowel training and exercises for the pelvic floor muscle and anal sphincter may help to restore muscle strength. A pressure-sensitive anal probe or surface patch electrodes can help you to practice muscle contractions (biofeedback). Electrical stimulation of the anal sphincter may also be helpful.
  • Medications to slow bowel movements, treat diarrhea, or soften or decrease the water content in stools can be used on an as-needed basis. They may require a physician prescription.
  • Neuromodulation techniques can help with symptoms when there is no anal sphincter defect present. Percutaneous tibial nerve stimulation is a non-surgical treatment that can be performed in the office/clinic. Sacral nerve stimulation involves implantation of the stimulator in the buttocks to send continuous impulses to the nerves.
  • Surgical interventions include anal sphincter repair (sphincteroplasty); artificial sphincter and injection of bulking agents to increase the size of the anal sphincter. A colostomy can be a temporary or permanent treatment of last resort.