Fecal incontinence refers to a person’s inability to regulate the release of stool or gas. Nearly 20% of adults over the age of 70 suffer from this affliction and approximately 10% of adults have experienced incontinence at least once in the past month. Although many adults are quite embarrassed by an occurrence of fecal incontinence, statistics show that it is actually quite common.
Causes of fecal incontinence:
- Injury to the sphincter muscle during child birth
- Injury from a prior surgery
- Abnormal stool constancy and volume
- Neurological disorders which can cause weakness in the sphincter muscle
How do we evaluate fecal incontinence?
Fecal Incontinence can be caused by several different factors. Thus, a thorough physical examination and review of medical history will be performed by Dr. Kamrava. After the initial evaluation, further analysis may be ordered by the doctor.
How do we treat fecal incontinence?
Often, our patients positively respond to a change in diet and utilization of biofeedback. Adding fiber to one’s diet can improve incontinence, as the fiber adds bulk and consistency to stool.
Initial treatment includes:
- Injectable bulking agents
A post-evaluation trial period will designated, after which Dr. Kamrava will determine if a conservative dietary plan will suffice or if further intervention is required.
If patients do not respond positively to these treatments, sacral nerve stimulation is utilized. Sacral nerve stimulation has shown to be particularly effective for patients suffering from neurological disorders or fecal incontinence resulting from lower anterior resection. Electrical stimulation includes the use of electrodes to provide minor electrical stimulation. If patients respond positively to the initial sacral nerve stimulation, a permanent electrode connected to a subcutaneous stimulator.
Although studies show fecal continence improvement from sacral nerve stimulation, a high percentage of patients will require surgical intervention following sacral nerve stimulator implantation.
Adverse effects resulting from sacral nerve stimulator implantation include:
- Implant-area pain (28%)
- Paresthesia (15%)
- Changed stimulation sensation (12%)
- Infection (10%)
Please note, 41% of patients require surgical revision within 4 years of the initial procedure.