​Faecal or Bowel Incontinence

Faecal incontinence is an uncontrolled bowel movement that causes stool to leak from the anus with or without your knowledge. You may not be able to hold it in until you reach the toilet.

It can be caused by diarrhoea, constipation, and muscle or nerve damage around the anus or rectum. Faecal incontinence can affect children and adults, men and women. More women suffer from faecal incontinence then men due to vaginal childbirth that can damage the anal sphincters or their nerves.

 

Most children and adults may suffer from faecal or bowel incontinence when they have diarrhoea. Long term (chronic) or recurring faecal incontinence is when there is an:

  • Inability to control the passing of stool, solid or liquid, from the bowels.

  • Inability to reach the toilet on time.​​

If you or your child suffers from this disorder, consult one of our expert specialists in the GI and Surgery Service Line​ at The Aga Khan University Hospital.  You may be reluctant to discuss faecal incontinence with anyone due to embarrassment, but our doctors are extremely professional and will do their best to relieve you of this uncomfortable disorder. You can lead a healthy quality of life​.
​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​
​

Initially your doctor will take a medical history and may ask detailed questions about your condition. This may be followed by a physical examination of your anus and rectum. To determine the cause of the disorder, a number of tests may be carried out:

  • Anal manometry to check the strength of the anal sphincter muscles by inserting a small thin, flexible tube, with a small balloon at the end. This is inserted into the rectum via the anus. The balloon may be expanded to test the tightness, sensitivity and functioning of your sphincter muscles.

  • Anal electromyography to determine whether nerve damage is the reason behind the malfunctioning of sphincter muscles.

  • Proctosigmoidoscopy is a test in which the last two feet of the colon (sigmoid) are inspected for inflammation, tumour or scar tissues. This is done by inserting a flexible thin tube, with a camera attach at its end, into the rectum to view the linings of the bowel.

  • Proctography is a test in which the stool holding capacity of your bowel and stool expelling capability of your body is evaluated. An X-ray video is taken by releasing liquid barium into the rectum.

  • Anorectal ultrasound in which a small probe-like instrument is inserted into the rectum via the anus to produce video images that are studied by your doctor to evaluate the sphincter muscles’ structure.

  • Colonoscopy in which a flexible tube is inserted to check the entire colon.

  • Magnetic Resonance Imaging (MRI) to evaluate the pelvic organs by getting clearer images.​


There are various treatment options and your doctor will suggest a suitable treatment depending on the exact nature of your faecal incontinence. These may include:

  • Dietary changes to eliminate or include food and drinks that lead to loose stools or constipation.

  • Bowel training to establish a fixed routine of emptying your bowels. This can lead to greater control of your bowel movements.

  • Medications such as anti-diarrhoeal drugs, bulk laxatives, fibre supplements or injectable bulking agents.

  • Exercise therapies to help increase the anal muscle strength.

  • Surgery may be recommended when none of the above mentioned treatments are effective. In cases such as rectal prolapse or sphincter damage, the following surgical procedures may be carried out:

    • Sphincteroplasty in which the damaged or weakened anal sphincter is repaired.

    • Sphincter replacement in which the damaged anal sphincter is replaced with an artificial anal sphincter. The device keeps the anal sphincter shut until you need to have a bowel movement.

    • Sphincter repair in which a muscle, taken from the inner thigh, is used to strengthen the sphincter muscles.

    • Colostomy in which the stool is diverted through an opening in the abdomen into a surgical bag. It is usually used as a last resort.​


The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
 
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
 
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage. ​
​


The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.