Diagnosis Of Fecal Incontinence

When you visit your physician regarding fecal (bowel) incontinence, the first step will be to determine the cause of your condition. To establish the degree of your problem, the doctor will ask health-related questions, take medical history and preform some medical tests.

A number of medical tests are available for diagnosis of fecal incontinence. They help pinpoint the causes of the problem. They may include:

Physical exam

The physical exam usually includes a visual inspection of your anus and the surrounding tissue. The doctor will also look for hemorrhoids, infections and other conditions. This is a quick way to identify an obvious injury to the anal muscles. The doctor may also use a pin or probe to check for nerve damage.


Anal manometry

In a test called anal manometry, a small flexible tube is placed into your anus and rectum. The test measures the tightness of your anal sphincter and the sensitivity and function of your rectum.


Anorectal ultrasonography

Anorectal ultrasonography is a test that evaluates the structure of the sphincters. A small wand like device (transducer) is inserted into your anus and rectum. The instrument, attached to a computer and video screen, emits sound waves, which bounce off the walls of your rectum and anus, creating images of the internal structure of the rectum and sphincters. The opening of anus is controled by two sphincters.


Proctography

With a test called proctography, also known as defecography, the doctor measures how much stool your rectum can hold and evaluates how well stool is evacuated from your rectum. A small amount of liquid called barium is used, which coats the walls of your rectum and makes it more visible on X-rays.


Proctosigmoidoscopy

In this procedure a long, slender tube with a tiny video camera is inserted into the rectum. This allows doctors to look inside the rectum for any signs of disease or other problems that could cause fecal incontinence, such as inflammation, infections, tumors, or scar tissue.


Anal electromyography

By inserting tiny needle electrodes into the muscles around the anus doctors check for any signs of nerve damage.


Many clues to the origin of fecal incontinence may also be found in patient's history. A woman's history of past childbirths is very important. Multiple pregnancies, large weight babies, forceps deliveries, or episiotomies may contribute to anal muscle or nerve injuries. In some cases, medical illnesses and medications play an important role in problems with bowel control.