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What Causes Bowel Control Problems?

Bowel incontinence is an inability to control bowel movements. Also known as fecal incontinence, the condition is similar to urinary incontinence (UI) in that the severity of the problem can vary. Some individuals may have slight stool leakage when passing gas, while others may have a complete loss of the ability to control their bowel movements. For some people, this may be an embarrassing problem – however there are treatments that can be helpful.

What Causes It?

Bowel incontinence is sometimes caused by nerve-related issues or damage to a group of muscles around the end of rectum called the anal sphincter that control stool release. Intestinal and rectal muscles may also be weakened over time by chronic constipation; other times rectal walls are affected by surgery or radiation treatment for inflammatory bowel disease (IBD). Risks factors and other causes associated with bowel incontinence include:

  • The rectum dropping into the anus (rectal prolapse)
  • Hemorrhoids that keep the anus from completely closing
  • Nerve damage affected by conditions like diabetes and multiple sclerosis
  • Rectal protrusion into vagina in women (rectocele)
  • Being 65 and older
  • Childbirth
  • Having late-stage Alzheimer’s disease or dementia

Some people only have occasional bowel incontinence when having diarrhea, while other individuals are simply unable to control the urge to defecate. Related signs and symptoms could include constipation and recurring issues with gas and bloating.

Treatment Possibilities

Bowel incontinence treatment recommendations will be based on the severity of the problem and the symptoms experienced. If the problem isn’t too severe, patients may be advised to make diet changes, drink more water to prevent constipation, perform Kegels and similar pelvic muscle exercises to strengthen anus/rectum-supporting muscles, and schedule bowel movements throughout the day. Treatment may also involve:

  • Medication to control bowel movements
  • Biofeedback
  • Sphincter surgery to make anal muscles tighter
  • Sacral nerve stimulation with an implantable device to stimulate pelvic nerves
  • Use of a sphincter cuff device to help control the anal sphincter
  • Surgical redirection of the colon through an artificial opening (colostomy)
  • Injectable materials like silicone or collagen to thicken the anal sphincter
  • Radiofrequency remodeling by using heat to purposely injure sphincter muscles so they’ll thicken when healing
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