Treatment options for fecal incontinence

Topic:

Treatment options for fecal incontinence

Purpose:

Fecal incontinence is a sensitive topic which patients are uncomfortable to discuss in public. While urinary incontinence products are seen in everyday social media, fecal incontinence has few literature and educational material available.  Fecal incontinence is the involuntary loss of gas or stool.  It affects 10 to 15% of the general population.  If not treated, the patients can retreat to social isolation; compromising their quality of life.  In the past, WOC nurses concentrated on skin protection and containment devices, but now there are other options available such as medication, dietary modification, physical therapy and surgical intervention.

Objective:

In our university hospital clinic, we have a Pelvic Floor Disorder Program with multiple specialty providers. Once a patient is referred for fecal incontinence, our colorectal surgeon will provide a thorough assessment and diagnostic testing of the patient.  They are offered multiple treatment options and showed some improvement after treatment.

Outcome:

From November 2013 to November 2014, there were 39 patients with age ranging from 30 to 70. There were 30 females and 9 males.  We had the following findings:

8 patients were referred to physical therapy of which 6 improved.

12 patients had dextranomer-hyaluronate-NaCl injection of which 5 improved.

6 patients had sacral nerve stimulation of which 4 improved.

3 patients had surgery, of which 2 had diverting colostomy. All were satisfied with the outcome.

5 patients only needed diet modification.

5 patients did not follow up after recommendation.

WOC nurses are essential to coordinating and assisting with testing. They are also engaged in education, counseling with medication, biofeedback exercise and preparation for surgery.  An advance WOC practitioner can provide testing and more comprehensive treatment plan. The patients with fecal incontinence can improve their quality of life after treatments and additional research will be beneficial.