DEAR MAYO CLINIC: I have had fecal incontinence for the past year, since the birth of my second child. Is there a chance it will resolve on its own, or is surgery my best option?
ANSWER: Fecal incontinence is a common problem that may be caused by muscle or nerve damage sustained during childbirth. Surgery may be needed when symptoms are severe or damage to the anal sphincter muscle is permanent.
Other cases may not require surgery, however, and instead may be effectively treated with less invasive therapies, such as dietary changes and exercises.
Fecal incontinence is the inability to control bowel movements causing stool, or feces, to leak unexpectedly from the rectum.
A variety of situations can lead to fecal incontinence. One of the most common is injury during a vaginal delivery, particularly one that involves an episiotomy or extensive vaginal tears.
The injury may affect the rings of muscle at the end of the rectum, called the anal sphincter. Such an injury can make it difficult to hold stool back properly. In some cases, the nerves that sense stool in the rectum or those that control the anal sphincter may be injured, as well.
To determine the best treatment for your situation, start by having a thorough medical evaluation. It should include a discussion with your health care provider that covers the complete history of the problem, including what happened during childbirth. A physical exam, including a digital rectal exam, is important for your provider to be able to properly assess your condition.
An anal manometry test typically is a routine part of the evaluation, too. It involves inserting a narrow, flexible tube into the anus and rectum.
A small balloon at the tip of the tube may be expanded during the test. This test measures the tightness of the anal sphincter and the sensitivity and functioning of your rectum.