Can fecal incontinence be cured?
Most women with fecal incontinence get much better, and many get to where leakage no longer gets in the way of daily life. Which treatment fits you depends on what’s causing it.
Treatment options
First-line treatments:
- Diet changes: fiber supplements to firm up your stool, and cutting out foods that trigger leakage
- Pelvic floor physical therapy with biofeedback, which strengthens the anal sphincter and teaches the muscles to work together
- Anti-diarrheal medicine such as loperamide (Imodium) to firm up loose stool
If those aren’t enough:
- Sacral neuromodulation, sometimes called a “bowel pacemaker.” A small implanted device stimulates the nerves that control your bowel. The FDA approved it for fecal incontinence in 2011, success rates are high, and it can work even if you have a sphincter defect.
- Sphincter repair surgery. We rarely recommend it now. The repair tends to break down over the years, recovery is painful, and infection rates are high.
Dr. Stewart’s perspective
“The approach depends on what’s causing the problem. If the nerves are the issue, sacral neuromodulation is excellent. It’s one of the most satisfying treatments I offer, because the improvement is often dramatic. For many women, pelvic floor therapy and dietary management provide substantial relief. I almost never recommend sphincter repair because the long-term results just aren’t there.”
References
- Brown HW, Dyer KY, Rogers RG. Management of Fecal Incontinence. Obstetrics & Gynecology. 2020. doi:10.1097/AOG.0000000000004054
- Meyer I, Richter HE. Accidental Bowel Leakage/Fecal Incontinence: Evidence-Based Management. Obstetrics and Gynecology Clinics of North America. 2021. doi:10.1016/j.ogc.2021.05.003
- Meyer I, Richter HE. Impact of Fecal Incontinence and Its Treatment on Quality of Life in Women. Women’s Health (London, England). 2015. doi:10.2217/whe.14.66
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology. 2019. doi:10.1097/GCO.0000000000000584
- DeLancey JOL, Miller NF, Berger MB. Surgical Approaches to Postobstetrical Perineal Body Defects (Rectovaginal Fistula and Chronic Third and Fourth-degree Lacerations). Clinical Obstetrics and Gynecology. 2010. doi:10.1097/GRF.0b013e3181cd4222
- Goldman HB, Lloyd JC, Noblett KL, et al. International Continence Society best practice statement for use of sacral neuromodulation. Neurourology and Urodynamics. 2018. doi:10.1002/nau.23596
← Learn more about Fecal Incontinence