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Is Major Surgery an Option?

“In a large percentage of cases, fecal incontinence can be controlled by conservative methods like diet and medications or by minimally invasive methods like InterStim Therapy. However, when they don’t work, there are surgical options that may be considered. Here is a brief summary of those options."

Dr. Liam Haveran

bowel training

Surgery may be an option for fecal incontinence that fails to improve with more conservative treatments or for fecal incontinence caused by pelvic floor or anal sphincter muscle injuries.

Sphincteroplasty, the most common fecal incontinence surgery, reconnects the separated ends of a sphincter muscle torn by childbirth or another injury. Sphincteroplasty is performed at a hospital by a colorectal, gynecological, or general surgeon.

Artificial anal sphincter involves placing an inflatable cuff around the anus and implanting a small pump beneath the skin that the person activates to inflate or deflate the cuff. This surgery is much less common and is performed at a hospital by a specially trained colorectal surgeon.

Non-absorbable bulking agents can be injected into the wall of the anus to bulk up the tissue around the anus. The bulkier tissues make the opening of the anus narrower so the sphincters are able to close better. The procedure is performed in a health care provider’s office; anesthesia is not needed. The person can return to normal physical activities 1 week after the procedure.

Bowel diversion is an operation that reroutes the normal movement of stool out of the body when part of the bowel is removed. The operation diverts the lower part of the small intestine or colon to an opening in the wall of the abdomen—the area between the chest and hips. An external pouch is attached to the opening to collect stool. The procedure is performed by a surgeon in a hospital and anesthesia is used. More information about these procedures can be found in the National Digestive Diseases Information Clearinghouse fact sheet Bowel Diversion at www.digestive.niddk.nih.gov.

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