Fecal Incontinence | Donna Sarna

What is Fecal Incontinence?

Fecal incontinence is the involuntary or inappropriate passage of gas or stool (solid or liquid). The incidence of fecal incontinence in the general population is approximately 2-3%. After childbirth the statistic for fecal incontinence is 7.2% with gas incontinence being up to 29%. Over half of women with fecal incontinence experience urinary incontinence. One or a combination of several factors can lead to fecal incontinence. These factors include:

Vaginal childbirth

Damage to or weakness of the anal sphincters

Pelvic floor weakness that may be due to chronic straining or radiation or as a result of compromise of the pelvic floor secondary to vaginal birth

Damage or irritation of the nerve (pudendal) of the pelvic floor

Medical conditions (Crohn’s disease, ulcerative colitis, irritable bowel syndrome)

Congenital abnormalities (spina bifida, myelomeningocele)

Cognitive impairments (stroke)

Age

What are the Signs and Symptoms?

Fecal urgency

Loss of bowel control (partial or full)

Fecal leakage (liquid to formed stool)

Loss of control of passage of gas

Rectal pain/heaviness

Breakdown in skin integrity as a result of the leakage of stool

How Can Donna Sarna Physiotherapy Help?

At Donna Sarna Physiotherapy & Rehabilitation, a pelvic floor assessment is a two-part process with a global approach taken both with assessment and with treatment. During the assessment process, a detailed history as well as an internal and external evaluation will occur incorporating not just the pelvic floor, but also assessment of posture, as well as range of motion and strength of the torso, back, hips, pelvis and lower extremities and examination of the associated musculature and fascia as well as the nerves and joints. The pelvic floor component will include an external evaluation of the skin and connective tissue in the perineal and genital area as well as an internal examination of the vagina and anal canal. The pelvic floor muscles and sphincters are tested for muscle tone and tightness, strength, endurance, trigger points, and tissue integrity. The pelvic floor is also assessed in conjunction with the rest of the core to ensure that timing of activation and sequencing of the muscles is optimal. Position of the pelvic organs and integrity of their supporting ligaments and fasciae are also evaluated. You are always welcome to have a trusted individual present during assessment or treatment.

An individual treatment plan is developed based on the assessment findings and may include education regarding posture, breathing, proper toileting techniques, bladder training/urge delay techniques, organ prolapse reduction techniques, bladder irritants, perineum care, perineum support and evacuation techniques and abdominal massage. Manual techniques including myofascial release, mobilization, visceral manipulation and biofeedback will also be utilized as a component of the treatment plan. An individualized home exercise program will also be provided to release and/or strengthen with a whole body approach to include the pelvic floor, but not specific to. Other modalities such as electrical muscle stimulation (EMS), transcutaneous electrical nerve stimulation (TENS), biofeedback, ultrasound and acupuncture may also be included as components of the treatment plan.