Fecal incontinence (FI) is defined as the involuntary loss of feces. Fecal incontinence has been reported as high as 3% in the general population, however it increases among people with urinary incontinence and pelvic organ prolapse. The most common cause of fecal incontinence is a defect in the pelvic muscles and/or the anal sphincter. This defect most often occurs following the delivery of a child where extensive perineal tearing or an episiotomy can occur. Other causes of fecal incontinence include abdominal or pelvic surgery, pelvic organ prolapse, injury to the pelvic nerves, and weakness of the pelvic floor muscles.
Symptoms associated with fecal incontinence:
Inability to control the passage of gas or stool which may be liquid or solid
Inability to make it to the toilet on time
Minor “streaking” of stool in underwear
Complete lack of control and full loss of liquid or solid stool
Often accompanied by other issues such as constipation, diarrhea, bloating, gas
Typically, a primary care physician will refer patients with FI to a gastroenterologist (GI doctor). The GI physician may perform tests to determine the cause of the FI. These tests may include: digital rectal exam, balloon expulsion test, anal manometry, anorectal ultrasonography, proctography, proctosigmoidoscopy, endorectal ultrasound, colonoscopy, anal electromyography, and MRI.
Treatment for fecal incontinence is based on the cause and outcome of the testing. Typically, treatment consists of medications, dietary changes, and exercises. At Rebalance Physical Therapy, our treatment for fecal incontinence consists of a holistic approach beyond simply strengthening pelvic floor muscles. We differ from traditional therapy by looking at the whole body to identify contributing dysfunctions. Evaluation and treatment is individualized. We use the Integrated Systems Model (ISM) for Pain & Disability (Lee & Lee, 2007) as framework for treatment to interpret the unique picture of the individual. The goal of the ISM approach is to facilitate better strategies for posture and functional movement to ultimately eliminate the fecal incontinence issues.
Incontinence is often accompanied by underlying postural dysfunction. The dysfunction brings with it other muscular gripping patterns which put increased intraabdominal pressure on the pelvic organs hindering their function. All areas of the body are linking and interacting with each other during daily body function, including bowel function. By considering the connections between parts of the body and treating the underlying postural or movement dysfunctions, the fecal incontinence is better reasoned, explained and treated appropriately.
