What Causes Bowel Incontinence?

Posted on Sat, 18 Jun 2016

Question: Please help me. I have no idea what to do. I am only 48 years old and I am suffering from bowel incontinence. I have had a ton of tests done for different autoimmune problems among some other things. All tests come back normal. I have Graves Disease but it is very much under control. I have had the following test come back normal.
Upper and lower scope. (Endo and Colonoscopy)
MRI of Brain
CT of Pelvis and Abdomen with contrast- (showed a small cyst on ovary/ no fluid)
Bloodwork fairly normal
Pap Smear and exam year ago was normal
I tried dieting with low carb. Salad , nuts and fruit caused me incontinence issues
so I went back to normal eating, gained weight back and still have incontience.
I can't even tell it is coming out. It is not like diarrhea. I am a tennis player and instructor. It is interfering with my work and play. No one can seem to figure out what is wrong. PLEASE HELP ME!!! I was a chaperone on a DC trip with my school rhis past weekend and had a difficult time because of this problem.There has to be help for this!!

Answered by Dr. Ashwini Kolur (4 hours later)

Brief Answer:
anal manometry, colonoscopy and nerve test

Detailed Answer:
Hi
Welcome.
I have gone through your query.
Many of this conditions do not have clear cause.
As you have mentioned lots of tests have been done, so I suppose that the infection and IBS are ruled out.

I would have done thorough general physical examination and also I would have checked the strength of the anal sphincter muscle by digital rectal examination.

I would have asked for few of the tests, that I feel will be helpful and I think you have not mentioned about them here.
Anorectal manometry to check the pressure of the anus and rectum. This allows measurement of the strength of the sphincter muscles.
Colonoscopy and biopsy if required.
Nerve tests. These tests measure the responsiveness of the nerves controlling the sphincter muscles.

I would suggest you to see gastroenterologist for examination and for this investigations.

Dietary alteration that might be beneficial - eat 20 to 30 grams of fiber per day. This can make stool more bulky and easier to control.Avoid caffeine, spicy food, alcohol and smoking. This may help prevent diarrhea.Methylcellulose can help make liquid stool more solid and easier to control.
This provisional advice provided by me is based entirely on the input provided to me. I would suggest examination by the doctor.

I hope this suggestion might be of some help to you. Please accept my answer in case you do not have further queries.
Take care.

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Above answer was peer-reviewed by : Dr. Prasad