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Bowel incontinence

Show Alternative Names

Uncontrollable passage of feces

Loss of bowel control

Fecal incontinence

Incontinence - bowel

Bowel incontinence is the loss of bowel control, causing you to unexpectedly pass stool. This can range from sometimes leaking a small amount of stool and passing gas, to not being able to control bowel movements. Urinary incontinence is when you are not able to control passing urine. It is not covered in this article.

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Self Care

Ileostomy - caring for your stoma

The Basics

A Closer Look

Small bowel obstruction - x-ray

X-rays of the abdomen are important in diagnosing the presence of small bowel obstruction. When obstruction occurs, both fluid and gas collect in the intestine. They produce a characteristic pattern called "air-fluid levels". The air rises above the fluid and there is a flat surface at the "air-fluid" interface.

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Inflammatory bowel disease

Crohn disease, also called regional enteritis, is a chronic inflammation of the intestines which is usually confined to the terminal portion of the small intestine, the ileum. Ulcerative colitis is a similar inflammation of the colon, or large intestine. These and other IBDs (inflammatory bowel disease) have been linked with an increased risk of colorectal cancer.

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Small intestine tissue sample

A sample of small intestine is obtained by the use of a flexible scope that is passed through the digestive tract to the small intestine. In the small intestine, a small sample is removed and placed on a microscope slide. The sample is stained and sectioned (sliced) for histological (tissue) examination. The test is performed to diagnose an infection or parasitic infestation of the small bowel.

Illustration

Small intestine biopsy

Small bowel biopsy is a diagnostic procedure in which a portion of the small bowel lining is removed for examination. A flexible fiberoptic or video tube (endoscope) is inserted through your mouth or nose and into the upper gastrointestinal tract where a tissue sample is removed. This test is most often performed to help diagnose diseases of the small intestines.

Illustration

Small intestine contrast injection

Enteroclysis is a test performed to examine the small bowel. A tube is placed down the nose and throat, through the stomach into the small intestine. When in place, contrast dye is introduced and x-ray images are viewed on a fluoroscopic monitor to visualize how the contrast moves through the bowel structures. The enteroclysis test is the most complete means of demonstrating whether or not the small intestine is normal when abnormality is suspected.

Illustration

Colostomy - series

Presentation

<strong>Indications</strong><p>A colostomy is done when the lower large intestine, rectum, or anus is unable to function normally or needs rest from normal functions. Intestinal obstruction with associated inflammation, as in diverticulitis, is a common indication for colostomy.</p>

<strong>Procedure, part 1</strong><p>A colostomy creates an opening on the abdomen (stoma) for the drainage of stool (feces) from the large intestine (colon). Colostomies are usually performed after the diseased colon has been removed. Colostomies may be temporary or permanent. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the abdomen. The diseased colon is removed.</p>

<strong>Procedure, part 2</strong><p>The proximal end of the healthy colon is then brought out to the skin of the abdominal wall, where it is sutured in place. An adhesive drainage bag (stoma appliance) is placed around the opening. The abdominal incision is then closed.</p>

<strong>Aftercare</strong><p>In more than 90% of the cases, the surgery is successful. The patient may experience considerable pain after surgery as the anus tightens and relaxes. Medications to relieve pain may be used. To avoid straining, stool softeners will be used. Avoid any straining during bowel movement or urination. Soaking in a warm bath can bring additional comfort. Depending on the disease process being treated, colostomies can be taken down and the colon reconnected in a second operation within weeks to months after the first operation.</p>

Colostomy - series

Presentation

Small bowel resection - series

Presentation

<strong>Indications</strong><p>Resection of the small bowel may be recommended for Blockage of the intestine (intestinal obstruction) due to scar tissue or deformities; Bleeding, infection, or ulcers due to inflammation of the small intestine (regional ileitis, regional enteritis, Crohn's disease); Injuries; Cancer; Precancerous polyps.
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<strong>Incision</strong><p>The patient is deep asleep and pain-free (general anesthesia). An incision is made into the abdomen.</p>

<strong>Procedure</strong><p>The diseased part of the small intestine (ileum) is removed. The two healthy ends are then sewn back together and the incision is closed. If it is necessary to spare the intestine from its normal digestive work while it heals, a temporary opening (stoma) of the intestine onto the abdomen (ileostomy) may be done. A temporary ileostomy will be closed and repaired later. If a large portion of the bowel is removed, the ileostomy may be permanent. The ileum absorbs much of the fluid from foods. When the large intestine is bypassed by an ileostomy, the patient should expect liquid stool (feces). The constant or frequent drainage of liquid stool can cause the skin around the ileostomy to become inflamed. Careful skin care and a well-fitting ileostomy bag can reduce this irritation.</p>

<strong>Aftercare</strong><p>The outcome depends on the disease. Most patients will stay in the hospital for 5 to 7 days. Complete recovery from surgery may take 2 months. During the first few days after surgery, eating is restricted.</p>

Inflammatory bowel disease - series

Presentation

<strong>Indications</strong><p>Inflammatory bowel disease is a condition in which the innner lining of the GI tract becomes inflamed, leading to ulcers and bleeding. The colon is most often the site of this inflammation. Patients with inflammatory bowel disease have symptoms that include diarrhea, abdominal pain, infections, and bleeding. Inflammatory bowel disease falls under two main headings Crohn's disease, which involves the entire GI tract, and ulcerative colitis, which involves only the colon. The cause of inflammatory bowel disease is unknown.</p>

<strong>Incision</strong><p>The primary treatment for inflammatory bowel disease involves medications, such as steroids, which can decrease inflammation and resolve symptoms. Occasionally, if segments of bowel are very inflamed and are not responding to medication, surgery to remove these segments may be necessary. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the midline of the abdomen.</p>

<strong>Procedure</strong><p>The inflamed segment of the colon or small intestine is removed and the healthy ends are sewn back together.</p>

<strong>Aftercare</strong><p>The removal of one section does not preclude recurrence of symptoms in other areas of the intestine. The course of inflammatory bowel disease is often variable. Some patients experience only mild symptoms, while others have more debilitating symptoms.</p>

Review Date: 10/31/2022+

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