Treatment of Incontinence, faecal

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Treatment focuses on identifying the cause of these symptoms. Management may include:

Medication- if symptoms are mild, infrequent, and not due to impaction with overflow. Loperamide or codeine phosphate, available without prescription in the UK are often safe and very effective. These can benefit patients with soiling or passive leakage and those with urge incontinence. Loperamide can be used as required or continuously. It reduces motility of the large bowel and increases absorption, making the stool more formed. Anticholinergic medications work by reducing contractions in the colon
Pelvic floor exercises
Dietary management of diarrhoea including introducing bulking substances such as fibre which adsorbs stool water thereby thickening the consistency of stool.
Certain people are unable to digest lactose so may develop diarrhoea, lactose should therefore be avoided.
A disposable enema or manual evacuation of faeces may be used in the treatment of faecal impaction. After the bowel has been cleared, preventive measures must be taken with an adequate intake of fluids, fibre and exercise to enhance normal stool consistency.
Biofeedback which aims to condition patients to be more sensitive to the stimulus of a full rectum and to heighten the voluntary striated muscle sphincter response. Sensors are placed on an anus to help identify muscles that help maintain continence. People who experience faecal incontinence despite medical management, may also require surgery.

The most common types of surgery include:-

Sphincter repair

This is performed when the sphincter has been injured or as a result of aging, leading to a gap in the sphincter muscles. The sphincter repair aims to reattach the rectal muscles to tighten the sphincter and increase the capacity of the anus.

Muscle Transplant

In people with loss of nerve function within the rectal sphincter, muscle transplants are performed to restore faecal continence This is a technique involves transferring a muscle from another part of the body and wrapping it around the anal canal to act like a sphincter.

Colostomy

If all other treatment measures fail, colostomy is a treatment alternative for relieving faecal incontinence. A colostomy diverts stool into an appliance attached to the skin, thereby eliminating leakage of stool from the rectum.