Tests for Fecal Incontinence

Fecal incontinence refers to the inconvenient and possibly embarrassing incapacity to control your bowel movements. The symptoms of fecal incontinence (also referred to as bowel incontinence) range from sporadic leakage of stool (feces) while passing gas to a total, unexpected loss of bowel control. There are a variety of tools your doctor may use to help diagnose fecal incontinence.

Causes

• When your rectum, anus and nerve system are operating as they are designed to you are naturally able to hold in stool (feces). If something goes haywire with any of these structures, the result can be fecal incontinence. This condition can also cause abdominal pain, bloating, diarrhea, constipation and gas.

Who's at Risk?

• Fecal incontinence can strike at any age, but occurs more frequently among older people. Women are more likely than men to develop the condition since it is often a complication of childbirth.

  People who are physically disabled or suffer from conditions that cause nerve damage may be at a higher risk of fecal incontinence.

Diagnosing Fecal Incontinence

• Your doctor will conduct a physical examination that may include a check of your anus and the surrounding area to see if hemorrhoids or other abnormal conditions exist. He may also probe the area with a pin to test for possible nerve damage.

Digital Rectal Exam

• One of the medical tests available to help determine the cause of fecal incontinence is a digital rectal exam. During this procedure your doctor inserts a gloved and lubricated finger into your rectum to examine the strength of your sphincter muscles and to search for any irregularities.

Anal Electromyography, Manometry and Anorectal Ultrasonography

• An anal electromyography consists of inserting tiny needle electrodes into muscles around your anus that will disclose signs of nerve damage.

  During anal manometry your doctor inserts a thin, bendable tube into your anus and rectum. A tiny balloon at the tip of the tube may be expanded. This test shows how tight your anal sphincter is and reveals the sensitivity and function of your rectum.

  An anorectal ultrasonography sends out sound waves that bounce off the walls of your rectum and anus. The interior structures appear on a computer monitor to be viewed and studied.

Proctography and Proctosigmoidoscopy

• Proctography, also known as defecography, will reveal how much stool the rectum can hold, how effectively the rectum holds it and how well the rectum can relinquish it. Your doctor will use a small amount of liquid called barium to coat the walls of your rectum making it more visible on X-rays.

  Proctosigmoidoscopy allows doctors to look inside the rectum and lower colon for indications of conditions that may be causing fecal incontinence such as inflammation, scar tissues and possibly tumors. During this test, your doctor uses a long, thin tube with an attached video camera attached to examine your rectum and sigmoid (the last 2 feet of your colon).

Treatment

• Your doctor may recommend anti-diarrheal drugs such as loperamide (Imodium) to help alleviate diarrhea.

  Sometimes medications that reduce the impulsive motion of your bowel (bowel motility) or diminish the water content of your stool may be prescribed.

  In addition your doctor may also suggest dietary changes to help rectify fecal incontinence.