Areas of Expertise
About Fecal Incontinence
Fecal Incontinence is the inability to control gas or stool with leakage of these contents out of the anal canal. It ranges in severity from occasional leakage or staining to complete inability to retain any stool. It is often associated with aging, previous vaginal delivery, or prior surgery that cause damage to the sphincter mechanism.
Diagnosis of fecal incontinence involves carefully going through a patient’s symptoms to further grade the degree of continence, which can be mild, moderate, or severe. The Cleveland Clinic Incontinence Score is the most common way to determine this. It represents the sum of 5 parameters scored on a scale of 0 to 4, with values represented as follows: 0 (absent), 1 (less than 1/month), 2 (monthly), 3(weekly), 4(daily). Each score is applied to 3 different stool parameters: (leakage of gas, liquid, and solid stool) as well 2 functional parameters: (the need to wear a pad and the frequency of lifestyle modification due to incontinence). Scores range from 0 (completely continent) to 20 (completely incontinent).
After symptoms have been fully characterized, a search for the underlying cause is performed. Additional testing including manometry, ultrasound, and radiology examination may be helpful in determining the best form of treatment.
Treatment for Fecal Incontinence
Treatment of fecal incontinence involves a stepwise approach of various available treatments. There is no one treatment that works exceptionally well, and it is often a trial and error method to see what improves symptoms.
Non surgical treatments include: stool bulking agents such as fiber, dietary modification, and medications that can alter stool transit times. For some patients, these simple tricks can improve incontinence.
Surgical treatment options include a number of procedures including Secca®, sphincteroplasty, sacral nerve stimulation, artificial bowel sphincter, injection of bulking agent around the anus, and more. All of these procedures are available at USC. Speak to one of our specialists to determine which of these is best for you. Many of these procedures are new and innovative, and our specialists can best advise you how to proceed. Incontinence can be a frustrating ordeal and no one therapy works bests for everyone.
To learn more, visit the American Society of Colon and Rectal Surgeons website: