Fecal Incontinence and Bowel Motility Disorders

Bowel or intestinal motility disorders refer to a number of conditions in which the gut has lost its ability to maintain normal contractions. Abnormal intestinal contractions may include spasms or paralysis. They may cause a variety of symptoms including abdominal distention, obstruction, pain, constipation, gastroesophageal reflux disease, and vomiting. Intestinal motility disorders may be primary conditions or they may arise as secondary complications to other health problems.

The Division of Colorectal Surgery understands the distressing, even devastating effects that fecal incontinence and bowel motility disorders can have on patients' quality of life. We work with patients to accurately assess and effectively treat these disorders so that you may enjoy life as it was, with your freedom and independence restored.

Our team is available for second opinion consultations for anyone who wishes to confirm a diagnosis or discuss treatment options.

Causes of Fecal Incontinence and Bowel Motility Disorders

Fecal Incontinence, an inability to control bowel movements, can occur for many reasons. It may be caused by an abscess or inflammation in the rectum, anus or perianal area. Other causes include damage to the anal sphincter from trauma, complications during childbirth, or the result of a previous operation. It can stem from an injury or disorder of the nervous system. Fecal impaction or muscle atrophy in an elderly patient can also lead to incontinence. While age-onset incontinence is less responsive to surgical treatment, surgical correction can be performed in some instances, especially if the underlying cause of the incontinence is anal sphincter abnormality.

Treatment for Fecal Incontinence and Bowel Motility Disorders

We adopt a multidisciplinary approach to the assessment and surgical management of fecal incontinence, bowel dysmotility, constipation and pelvic floor disorders including outlet dysfunction, and others.

With the help of additional specialized radiologic evaluation, investigation and diagnosis of specific disorders amenable to surgery is feasible. Anorectal manometry, endoanal ultrasound, and biofeedback are useful adjuncts available in our offices. A variety of minimally invasive procedures and surgical options may be available to manage fecal incontinence, constipation and pelvic floor and outlet dysfunction. It is necessary to understand the cause of these disorders in order to determine the appropriate choice in surgery.

Biofeedback, sphincter (Kegel) exercises, and dietary and liquid management may be tried initially. For certain individuals, especially in cases of severe incontinence or incontinence due to childbirth injury, surgery may be recommended. Surgery is particularly effective at repairing injury to the anal sphincter. Surgical treatments may either repair or augment the sphincter mechanism, or they may constrict the sphincter using the patient's own tissue or an artificial device. Other surgical alternatives such as total pelvic floor repair, gluteoplasty, graciloplasty, and others may also be used. Research on sacral nerve stimulation is promising, and research continues to improve on many of the above procedures. Surgery may also be effective in the management of slow transit constipation and outlet dysfunction causing constipation.