Issue No. 14
Take ControlDate: October 12, 2011
If you have fecal incontinence, a newly approved treatment might be the solution you’ve been seeking
It’s understandable that people don’t like to talk about their fecal incontinence. But they should say something: Dialogue with a physician opens the possibilities to treatment, including one recently approved by the U.S. Food and Drug Administration (FDA).
Fecal incontinence occurs when a faulty rectum or sphincter muscle causes loss of bowel control. One standard therapy, a surgical procedure to tighten the sphincter, isn’t ideal, considering the fairly high rates of infection and discomfort, says Susan Gearhart, M.D., a colorectal surgeon at Johns Hopkins. Collagen injections are also used, but they’re not a permanent solution.
The newly FDA-approved treatment for fecal incontinence, called sacral nerve stimulation, has been used for about 10 years to help people with urinary incontinence. A device about the size of a silver dollar is implanted in the upper buttocks and delivers tiny electrical pulses that stimulate the nerves related to the rectal and sphincter muscles.
Johns Hopkins is one of very few institutions nationwide currently offering this therapy. Especially for patients who have tried other treatments unsuccessfully, it’s an option well worth exploring. Johns Hopkins employs a team of urogynecologists, urologists, colorectal surgeons and gastroenterologists.
“If you decide to undergo this type of therapy, you need a team like we have with experience in this apparatus,” Gearhart says. “It’s important for people with fecal incontinence to come forward. It’s nothing to be ashamed of, and we have better options than ever to help.”
Cause and Effect
- Nearly 18 million adults in the U.S. experience fecal incontinence.
- Fecal incontinence is more common in older adults and slightly more common in women.
- Primary causes include nerve damage from strenuous defecation and injuries to the sphincter muscle during childbirth.
- There are two kinds of fecal incontinence: Urge incontinence is the sudden need to have a bowel movement. Passive incontinence is loss of bowel control.
- Treatment options depend on the type of fecal incontinence. An ultrasound of the inside of the anus is one method used to evaluate a patient’s fecal control.
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