What is fecal incontinence?
Fecal incontinence is the involuntary loss of stool that causes a severe burden on one’s social and economic life. Many patients suffering from this condition that do not seek help are confined to living within the walls of their home to prevent any public accidents, preventing them from living a fulfilling lifestyle. Fecal incontinence can occur due to weakening of the anal sphincter, which is the muscle responsible for keeping stool in the rectum until one is ready to have a bowel movement. Chronic constipation is a risk factor to developing fecal incontinence as the constant straining to have a bowel movement may weaken the anal muscles over the years.
What can be done to help my fecal incontinence?
First, to evaluate the strength and structure of both the internal and external anal sphincters, Dr. Shakiba performs an anal ultrasound himself in office. This type of sonogram takes no more than 10 minutes and allows him to visualize the sphincters and detect if there are any deficits or if they are intact. Assuming both sphincters are intact, Dr. Shakiba may also perform an “anal manometry” procedure. This procedure is also done in office by Dr. Shakiba himself and last about 45 minutes. Dr. Shakiba does these procedures in office so that the results are immediate and he can consult with the patient immediately afterwards and discuss all of the findings.
Dr. Shakiba may recommend dietary modification as well as adjust any necessary medication to make the stool more solidified and compact to prevent leakage of loose, watery stool. For patients with more severe fecal incontinence, there is also the possibility of placement of an Interstim Neurostimulator device. The interstim device is surgically placed subcutaneously in the lower sacral or gluteal region. The purpose of the device is to conduct an electrostimulation current along the nerves that are responsible for communication between the brain and bowels. This stimulation allows the brain to communicate to the bowels that it is not ready to have a bowel movement yet, preventing the sphincters from relaxing and unintentionally releasing stool. The device is small and is virtually unnoticeable under clothes.
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