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Incontinence is the inability to control gas (mild incontinence) or stool (severe incontinence). It is a common problem although only a small minority of the patients with fecal incontinence actually seek medical advice due to embarrassment.
Injury during childbirth is the most common cause. These injuries result in a tear in the anal muscles or damage to the nerves that supply them. Initially the majority of patients are asymptomatic but typically it becomes clinically significant later in life.
Anorectic procedures or anorectic trauma can also compromise the anal muscles. With advancing age the symptoms of incontinence become more pronounced.
If bleeding, diarrhea or mucous discharge is associated with onset of incontinence then a colorectal specialist should be consulted since colitis, a rectal tumor and/or rectal prolapse may occur requiring prompt attention.
A patient's history can provide invaluable information. A difficult pregnancy or labor and delivery can serve as a clue for the diagnosis of fecal incontinence. In other cases, medical illnesses such as diabetes, multiple sclerosis, paraplegia etc., can contribute to incontinence.
For a true diagnosis a physical exam is required which may include the use of an ultrasound probe within the anal area to visualize the muscles and associated injuries as well as anal manometry to assess the function of the nerves.
Depending on the cause of the incontinence your physician may use constipating medications or recommend Kegel's exercises, biofeedback or surgical repair including insertion of an artificial sphincter. The last resort treatment for severe incontinence is creation of a colostomy.