Fecal incontinence is the inability to control bowel movements–a truly unpleasant condition for those who have experienced it first hand.  It is commonly seen among seniors when the muscles and ligaments that control defecation become less efficient.  A similar loss of control can be the result of abscess or inflammation in the rectum, anus, or perianal area, or from the trauma, injury, or surgery, as well as a nervous disorder like diabetic gastroparesis.  Chronic diarrhea may also be a contributing factor.  To address this condition, a bowel training program can be implemented, which involves sitting on the toilet at a certain time every day.  It is also a good idea to increases dietary fiber in the diet so that more normal stools are produced.  Biofeedback, self-hypnosis and surgery may also be helpful.

Self Help

It is important to talk to your doctor about fecal incontinence as the underlying causes could be serious.

Western Treatments

The treatment of fecal incontinence varies depending on the causes and symptoms.

• Anti-diarrheal drugs
• Laxatives, if chronic constipation is the cause
• Medications to decrease the spontaneous motion of your bowels
• Dietary changes –  Stool consistency is dependent on what you eat and drink so your doctor might recommend eating foods high in fiber, or drinking plenty of fluid, for example
• Exercise – Exercise can help fecal incontinence caused by muscle damage as it can restore muscle strength, sphincter control, and awareness of the urge to defecate
• Bowel training – Making a conscious effort to have a bowel movement at specific time of day can help establish greater control
• Sacral nerve stimulation – Implanting a device that sends small electrical impulses continuously to the nerves that control your pelvis can strengthen muscles in the bowels (this is usually done only after other treatments have failed)

Surgery

Fecal incontinence may require surgery to correct an underlying problem such as rectal prolapse, or sphincter damage.  The types of surgery available include:

• Sphincteroplasty - A procedure that repairs a damaged or weakened anal sphincter.
• Treating rectal prolapse, a rectocele or hemorrhoids - This sort of surgical correction will likely reduce or eliminate fecal incontinence.
• Sphincter replacement - An anal sphincter can be replaced with an artificial one, which is essentially an inflatable cuff placed in the anal canal.  It remains inflated until an external pump deflates the device and releases stool during defecation.
• Sphincter repair - This surgery takes muscle from the inner thigh and wraps it around the sphincter, restoring muscle tone.
• Colostomy - With a colostomy, stool is diverted through an opening in the abdomen into a special bag which collects it.  This is usually a last resort.

A Case Study in TCM Treatment

A 78-year-old patient first experienced incontinence after chemotherapy treatments for stomach cancer.  She confided that she was very worried about her adult son, who was a drug addict.  Traditional Chinese diagnosis found her pulse to be sinking and thin, and her tongue pale, flabby, and red at the tip.  She was prescribed a formula containing ailanthus cortex, baked astragalus root, White Ginseng root, White and Red Atractylodes rhizomes, poria sclerotium and a number of other herbs.  After four weeks, the patient observed she no longer experienced spontaneous evacuations, which greatly improved her self-esteem.