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A taboo topic - fecal incontinence

One of the most private times in our lives is while we are pooping. Due to how private we consider this process it is often taboo to talk about. This taboo makes fecal incontinence one of the least discussed topic of pelvic floor disorders despite the fact that it can be an incredibly common problem. In fact, many primary care providers do not even screen for fecal incontinence because of how sensitive of a topic it can be. There is hope for treatment though.

It is never normal, in any circumstance, for a woman to not be able to control her bowels (Liquid and or solid) and flatus (gas). There are several possible causes of this problem but the initial treatments are always the same. First it is advised to try dietary changes with the addition of pelvic floor exercises. The specific dietary changes are dependent on the current consistency of the stool. Your primary care provider or specialist should review this with you.

If home exercises do not work it can be beneficial to add a physical therapist or to start a muscle rehabilitation program like the one offered through our office. In addition to re training your pelvic floor muscles there are several medical intervention that can be helpful. If a woman is suffering from prolapse in addition to bowel incontinence a pessary or surgical repair of the prolapse may cure the bowel leakage but is not always the right solution. If there is a weakness to the sphincter or lack of rectal sensation a patient may benefit from a sacral neuromodulator (like a pacemaker for the bowel and bladder) or a sphincteroplasty (a repair of the circular muscle at the anus). A colorectal surgeon or urogynecologist can review the likelihood of success, and the potential risks and benefits of these options if you are considering them.

Because of the potential for many different treatment option it is important to discuss the problem opening with your primary care provider. There is no reason to continue to live with such a debilitating and embarrassing condition.


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