Bowel Dysfunction

Bowel incontinence can range from occasional leakage of a small amount of stool to a complete loss of bowel control. For many women, this condition results in social isolation and has a severe impact on their quality of life. 

Bowel dysfunction, or incontinence, may be uncomfortable for you to talk about if you have trouble controlling your bowels. But you’re not alone. It affects millions of Americans and is more common in women and older adults. It is also treatable and manageable, so you can get your life back. We can help.

We understand your challenges, and regardless of the cause, our pelvic floor experts and our colorectal specialists can help you overcome them. 

Causes & Risk Factors 

Normal bowel control depends on the proper function of your pelvic muscles, rectum (the lower end of the large intestine), sphincter muscles (the muscles in the anus), and nervous system. Bowel incontinence is usually caused when one or more of these body parts stop working properly. 

Causes of bowel incontinence include: 

• Certain foods
• Childbirth by vaginal delivery
• Chronic laxative abuse
• Complication from bowel surgery
• Constipation
• Diarrhea
• Hemorrhoids (swollen and inflamed veins around your anus or in your lower rectum)
• Loss of stretch in the rectum
• Muscle damage or weakness
• Nerve damage
• Physical or mental disability
• Radiation treatment for cancer
• Rectal prolapse (when the rectum falls from its normal position within the pelvic area)
• Tumors in the rectum
• Vaginal prolapse (when the vagina falls from its normal location inside the pelvis) 

Factors that can increase your risk for having bowel incontinence are: 

• Diarrhea three or more times a day
• Difficult childbirth with injuries to the pelvic floor
• Disease of the nervous system
• Poor overall health
• A sense of urgency prior to a bowel movement 

Symptoms & Seeking Care

Bowel incontinence may happen to you only occasionally or it may be a total lack of control. You should visit your doctor and discuss your symptoms if you are experiencing: 

• An inability to hold in gas
• An inability to reach the bathroom in time
• Frequent or occasional accidental leakage
• Silent leakage of feces during daily activities 

Diagnosis

It’s important to feel comfortable enough to discuss the details of your bowel movements with us. The more information we have, the better we can help you. 

Our multidisciplinary team provides a complete range of the most advanced diagnostic and treatment options available for bowel incontinence. 

When you first meet with us, a specialist will discuss your bowel habits, diet and health history. We will also do a physical exam. Bring a list of all your medicines to your appointment. Some medications, such as sedatives, antacids or muscle relaxers, can cause bowel incontinence. 

In addition to asking a series of questions about your bathroom habits. we may run some common diagnostic tests, including: 

• Anal electromyography—uses electrical stimuli to measure nerve or muscle damage
• Colonoscopy or endoscopy—uses a scope with a video camera to examine the anus and rectum
• Defecography—an X-ray test that shows the rectum and anal canal as they change during a bowel movement
• Digital rectal examination—a doctor uses fingers to physically examine the rectum
• Manometry—measures the function of the sphincter muscle
• Magnetic resonance imaging (MRI)—uses a magnetic field and radio waves to create detailed images
• Ultrasound—uses high-frequency sound waves to capture live images from the inside of your body

Treatment

Our experts include gynecologic surgeons, urogynecologists, and colon and rectal surgeons. Your care team will depend on your condition and needs. We offer advanced, effective treatment, so you can get back to doing what you enjoy.  

For some women, simple treatments can improve symptoms, such as: 

• Developing regular bowel movements
• Exercising to strengthen your pelvic floor muscles
• Making changes to your diet
• Using over-the-counter medicines
• Wearing absorbent pads 

Medical treatment 

Depending on the cause of your bowel incontinence, medical treatments for bowel incontinence may include: 

• Biofeedback—behavioral therapy used to treat people with bowel dysfunction
• Bulking agent—fiber supplements that absorb water from waste in the bowel making the stool firmer and reducing bowel leakage
• Manual stool impaction—treatment that removes a large, hard stool stuck in the rectum
• Medications—such as laxatives or stool softeners to help improve diarrhea and constipation
• Nerve stimulation—electrical stimulation to help eliminate leakage 

If medicine, lifestyle changes and other non-invasive treatments don't ease your symptoms, we offer advanced surgical treatment options including: 

• Hemorrhoid removal—to remove swollen and distended veins in the rectum or anus
• Prolapse rectum surgery—a procedure to repair the rectum when it protrudes from the anus
• Sphincter replacement—a procedure to replace a damaged anal sphincter
• Sphincteroplasty—a procedure to repair a damaged or weakened anal sphincter 
• Colostomy (last resort)—procedure that diverts stool through an opening in the abdomen 

Confusion about surgery can create fear and anxiety that sometimes delays treatment. We specialize in minimally invasive techniques that make it possible for women to recover faster, with less pain and fewer complications—so you get home sooner.