Let’s talk about fecal incontinence
Perhaps the most devastating problem I routinely care for is fecal incontinence. It mostly affects women, mostly post-menopausal, and they are usually left devastated, home-bound, unable to do anything they usually enjoy – go shopping, walking, visit their families – due to the unpredictable nature of their symptoms.
The tragedy of incontinence is usually compounded by the fact that patients don’t feel comfortable discussing their symptoms with their doctors (particularly male doctors, since patients are usually female).
Why does this happen? Let’s take a look at the anatomy of the human pelvis –
You can click on the image to make it larger. Notice that at the very bottom of the pelvic floor is a thin layer of muscle called the levator ani. This muscle plays a large role in maintaining urinary and fecal continence. When women go through menopause, they stop making hormones, testosterone among them. This loss of testosterone results in a decrease of muscle mass throughout the body. The levator ani is a small, thin muscle to begin with and is frequently damaged from childbirth or pelvic surgeries. When menopause occurs, this damaged muscle wastes away just enough to maintain continence and fecal and urinary incontinence frequently result.
So what can be done?
Fortunately, many things – but it’s often a process of trial-and-error to find the right thing or combination of things.
I frequently use a combination of bulking agents (fiber) and anti-diarrheal agents (at low doses) with good results. Pelvic floor physical therapy is another valuable treatment modality and is available in the Bayou region and elsewhere. Lastly, there is a new procedure available that’s done as an outpatient, in the office.
If you’re suffering from fecal incontinence, speak up! There’s no need to continue to be miserable and homebound. Talk to your doctor.
You can call us to book an appointment do discuss fecal incontinence or any other gastrointestinal problem at 985-601-2662.
Same-day appointments are (almost) always available.