Fecal Incontinence Treatment Near Appleton, WI
If you live in Appleton or elsewhere in the Fox Cities and you’re dealing with accidental bowel leakage, care is about 40 minutes away in Green Bay. Dr. Ryan Stewart is a board-certified, fellowship-trained urogynecologist who diagnoses and treats fecal incontinence and other pelvic floor conditions.
Understanding fecal incontinence
Fecal incontinence, also called accidental bowel leakage, is the involuntary loss of stool or gas. Some women feel a sudden urge and can’t make it to the bathroom in time. Others find soiling in their underwear without having felt anything.
About 9% of adult women leak stool at least once a month, and it gets more common with age. Fewer than 3 in 10 of those women ever ask a doctor about it, mostly out of embarrassment.
Most women have more than one cause at work. Common ones include:
- Childbirth injury to the anal sphincter muscles or nerves during vaginal delivery
- Nerve damage from diabetes, spinal conditions, or earlier surgery
- Weaker anal sphincter muscles with age
- Loose stools from conditions like IBS, inflammatory bowel disease, or chronic diarrhea
I know this is one of the hardest things to bring up with a doctor. I treat accidental bowel leakage all the time, and there are good treatments for it.
Learn more about fecal incontinence
Why see a urogynecologist?
A urogynecologist’s training centers on the pelvic floor. Depending on their path, a urogynecologist completes a 3-year fellowship after OB/GYN residency or a 2-year fellowship after urology residency, all of it spent on pelvic floor disorders.
Bowel leakage often comes with other pelvic floor problems, like urine leakage or prolapse. I can evaluate all of it at one visit and treat it together.
My approach
The word “doctor” comes from the Latin docere, to teach. I explain what’s causing your leakage and what each treatment involves, and then we decide together what to try. There is rarely one right answer, and the plan should fit what matters to you.
Convenient access from Appleton
Appleton is about 40 minutes from Green Bay, most of it a straight run up I-41:
- A drive that fits into a morning or afternoon
- Telehealth for many consultations and follow-ups, so not every visit needs the trip
- Office visits, testing, and surgery all in Green Bay
Most Wisconsin insurance plans are accepted, and no referral is needed.
Treatment options
Most women get better, and many get good control back. The main options:
- Diet and fiber. Loose stool is the hardest to hold, so we start by firming it up. A daily fiber supplement and cutting back on trigger foods often help a lot.
- Bowel habits. Going at regular times, such as after a meal, can give you more control.
- Pelvic floor physical therapy. A therapist works on muscle strength, coordination, and how quickly the sphincter responds to an urge, often with biofeedback so you can see the muscles working on a screen. We have pelvic floor physical therapists in the office.
- Medications. Anti-diarrheal medicine like loperamide (Imodium) firms up stool and cuts down on leaks. Constipation is the most common side effect, so we adjust the dose to you.
- Sacral neuromodulation, sometimes called a bowel pacemaker. A small implanted device stimulates the nerves that control the bowel. We do a trial first to make sure it helps you before placing the long-term device, and the battery lasts 10 to 15 years. It works even when the sphincter muscle is damaged.
I rarely recommend surgery to repair the anal sphincter. It can help in select cases, usually a recent childbirth injury, but the benefit tends to fade over the years, the recovery is painful, and the infection risk is high. For most women the bowel pacemaker works better and is far less invasive. I do not offer injectable bulking agents for fecal incontinence.
You don’t have to go through these in a fixed order. The right plan depends on what’s causing your leakage, how much it bothers you, and what you want to try.
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
- Jelovsek JE, Markland AD, Whitehead WE, et al. Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide: a randomized clinical trial. Lancet Gastroenterology & Hepatology. 2019. doi:10.1016/S2468-1253(19)30193-1
- 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
- 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
- Sultan AH, Monga A, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction. International Urogynecology Journal. 2017. doi:10.1007/s00192-016-3140-3
Schedule Your Appointment
40 minutes from Appleton, WI
Telehealth consultations available — start your care from home in Appleton.
- No referral necessary
- Now accepting new patients
- Most Wisconsin insurance plans accepted, including Anthem, Dean, Quartz, Network Health, and UnitedHealthcare.
- In-person and virtual appointments available
Schedule through Aurora BayCare
Or call (920) 288-8510 to book by phone.