[MUSIC] So fecal incontinence is
the inability to hold your bowel or to have control of your bowel. And this can be one episode or
daily episodes. And it results in soiling
in your underwear, and it can be quite uncomfortable. It usually is more commonly
seen in the elderly. About 10 to 15% of the population’s
affected by this disorder. [MUSIC] So fecal incontinence
can be multifactorial. One of the most common reasons
is starting a new medication. And that medication can result
in softening of your stool and make it harder for you to hold. Another common reason
is constipation. Patients who are constipated strain, and that straining can cause some
injury to those muscles over time. You can also develop hernias in your
pelvic floor from chronic straining. And that may change
the anatomy just a degree so that you can’t hold your stool
as well as you normally can. And finally, a common cause
is post-obstetrical injury to the sphincter muscles during
delivery, or to the nerves that innervate that sphincter muscle
during a prolonged labor. [MUSIC] So fecal incontinence is, the times that it’s related to
constipation can be prevented. But often, we can’t control the factors that
result in fecal incontinence. It’s probably best, if you do start
on a new medication, to find out if there’s any side effects related
to loosening of the stool or causing fecal incontinence. But the best thing is a healthy
diet, preventing constipation. That would be items like increasing
your fiber in your diet so that you don’t strain as much,
increasing your water intake. [MUSIC] So if someone delivers
a larger child or has difficulties with
prolonged labor, that can result in injury to
your muscles or to the nerves. If someone has long-standing
constipation, that is a risk factor for developing fecal incontinence,
resulting from either a pelvic floor hernia or from just isolated
injury to that muscle group. And then also, there has been some
data suggests that obesity can be related to development of fecal
incontinence, as it does also cause some changes in the pelvic floor and
its ability to do its job well. [MUSIC] So there’s several different
treatment options that are available. They range from medications that
can be used to slow down or thicken the stools
to surgical options. In between, there are some non or less invasive type of procedures
such as an injectable. Currently those are less difficult
or more difficult to obtain. But what they do is,
they inject into the muscle area and just cause some swelling or
thickening of the muscle area. And that helps to maintain
the stool inside the rectum. The newer methods that are less
invasive include sacral nerve stimulation. This is a electrode that’s placed
near the sacral nerve root, which helps to innervate
those sphincter muscles. And that innervation, that stimulus
to that innervated muscle group, causes that pressure to go up, and then you’re able to
hold your stool better. [MUSIC] The surgical options that
are currently available aren’t used quite as frequently, such as
an overlapping sphincteroplasty. Those are not shown to be as good in
terms of a longevity for a repair. The final option,
which is relatively new, which is really only for
compassionate use, is the implantable magnetic
sphincter called the Fenix. And that’s placed right around
the external sphincter and can actually increase or augment
the pressure of the anal canal, preventing the stool
from leaking out. [MUSIC] So at Johns Hopkins,
we offer a multidisciplinary care. The treatment of fecal
incontinence is multifactorial. There could be all multiple reasons
for this to be a problem for an individual. So we can have them see digestive
specialists in motility issues, we can have them see a urogynecologist,
all within the same building. And so we offer that
multidisciplinary team approach to the care of these patients, which I think really
optimizes their outcomes. [MUSIC]

9 thoughts on “Fecal Incontinence: Causes, Risk Factors and Treatments | Colorectal Surgeon Susan Gearhart”

  1. I was on a trip to New York where bathrooms are hard to find and most places don’t allow you to use them regardless of urgency. I was eating with someone who was upsetting me and though I have IBS D but had never experienced fecal incontinence … but 2x I had it…totally lost all control before I could get to a toilet. Can you have it just those two times or is this the beginning of something new? I’m scared that this will happen again although now I’ve been home a month and I’m fine. What do you think?

  2. Theres this one stinky kid at my school who has this shit and it is literally the nastiest small ever. Its been like 2 years and its only gotten worse. You literally smell shit before you see him. Is there really no fix for his leaky asshole? Its so fucking gross.

  3. I am female 65 slightly overweight have never been constipated always have had daily bowel movements. For the last year have had fecal incontinence, not runny but soft often don't realize it is happening. I do smoke cigs. Will losing some weight and changing to a plant based diet help, have also become lactous intolerant this past year. Thanks

  4. I have this with bleeding, nausea pain, dizziness :'( also have slow transit bowel.
    My life is a mess.. I am waiting finally after 7 yrs of hell to see a colorectoral specialist. I've seen a gastroenterologist. I'm increasing my fibre daily, drinking more water.

    Somethings not right here 🙁

  5. I'm 45years old. I've had fecal incontinence for 8 years now. I had colorectal cancer ,went through radiotherapy and chemotherapy. Surgery was done and a stoma placed for 9months . Fecsl incontinence started when the stoma was removed and I started using my anus again. Will my sphincter ever learn to control again or could it be a permanent damage caused by radiation? Please help

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