Fecal incontinence: New treatment options

June 3, 2013 Darren Pollock, MD

If you have been living with incontinence, you may have modified your daily activities around bowel movements.  Some people become homebound, fearing an accident in public. 

The good news is that you don’t have to live with incontinence.  Over the last few years, more treatment options have become available which can provide additional ways of improving lifestyle.

What is the cause of incontinence?

Both men and women can be affected by incontinence.  There are several causes of incontinence.  The most common causes include damage to the anal muscles or nerves during childbirth.

After a thorough history and physical examination, you and your physician will formulate a treatment plan that is right for you.  One or more treatment options may be recommended to address your particular symptoms. 

  • Injectable Bulking Agents  

Made from plant derivatives, bulking agents work by thickening the anal wall.  The bulking of the anal tissue allows for better control of the stool. 

Because the injection is given in an area above nerve endings, the procedure is typically not painful and does not require any anesthesia.  The injection is administered in the office and takes approximately 30 minutes to complete.  Depending on the results of the first treatment, some patients may need to return for a second injection after three months. 

  • Sacral Nerve Stimulation

Described by many as a pacemaker for the anus, sacral nerve stimulation utilizes an implantable, thin wire that sends painless electric pulses between the brain and nerves near the tailbone (sacral nerves). 

The sacral nerves control bowel function.  The electrical communication causes contraction of the sphincter muscles thus greatly reducing or eliminating incontinent episodes.

Sacral nerve stimulation is completed in two stages.  Both stages of the procedure are completed in outpatient surgery.  The trial lead is placed under the skin and is tested for two weeks.  During the trial period you will be asked to keep a diary documenting bowel movements. 

The completed diaries will help your doctor determine if placing a permanent wire is going to benefit you.  If it is the best option, a permanent wire will be placed in the same location.  If sacral nerve stimulation is not the best therapy, then your doctor will discuss other treatment options with you.


If you have questions about incontinence, or would like to make an appointment, please call (206) 386-6600.

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