How to Repair Fecal Soiling?

Fecal soiling can be an embarrassing problem. It is all too often unspoken, shielded by embarrassment, shame, or confusion over what is happening and what can be done. Commonly known as minor fecal incontinence or anal check leakage, fecal soiling is the involuntary passage of stool—usually in small amounts—without an individual noticing it in the act. If you are wrestling with this, know that you’re far from alone, and there are real ways, and effectiveness, to mend it.

What Causes Fecal Soiling After Potty Training and Why Does It Occur?

He described the fact that fecal soiling can have a variety of causes but is almost always a problem related to how the nerves and muscles interact properly. In a normal system, your brain signals both your pelvic floor muscles and anal fissure pics and your bowel when to keep stool in and when to let it out. If the system is disrupted — a nerve injury, surgery, chronic constipation, damage from childbirth, or just the aging process — you may lose some of your ability to control it. This can result in embarrassment when stool unexpectedly escapes, such as during physical activity or after a bowel movement – or even without any warning.

Hand weakness may be worse in people with conditions like diabetes, spinal cord disorders, or neurologic diseases. In some cases even patients without an obvious underlying disorder may suffer from chronic or recurrent soiling, if only because the muscles or tissue in the pelvic floor are weak or worn out.

What Are the Initial Steps in Managing Fecal Soiling?

The first thing to do if you’re seeing these kinds of signs of soiling is see a healthcare provider — usually a gastroenterologist, colorectal surgeon, or pelvic floor specialist. They will more than likely start with a thorough history and exam of you, followed by other testing which may include manometry (to measure sphincter pressure), endoanal ultrasound, or nerve testing. These can help to identify whether the issue is more muscular, neurological or structural.

Among the first treatments, perhaps involving lifestyle and dietary changes — adding fiber to your diet, retraining your bowel habits and taking medications that bulk your stool or slow its motility. Pelvic floor physical therapy and biofeedback to enhance muscle coordination may also be suggested. But with insufficient relief from these non-surgical methods, sacral nerve stimulation can be a strong next option.

What Is Sacral Nerve Stimulation?

SNS is a simple minimally invasive treatment that helps to re-establish the connection between your brain and the nerves that control your bowel. These nerves travel from the lower part of your back, near the tailbone, and help control the muscles in your pelvic floor, rectum, and anal lift sphincter. When they’re not firing correctly, fecal soiling can result.

Through a small, implanted device — similar to a pacemaker — SNS provides mild electrical stimulation to the nerves that control the bowel, regulating their actions. The aim is to increase your sensation of what is happening in your bowel retaining and regain voluntary control of your continence.

What’s the Process Like?

One of the key benefits of SNS is that it is divided into two trial phases. Patients wear a temporary external device for a week or two to test out before anything is portable. This allows you to “test drive” the stimulation and determine how effective this is for you in decreasing your soiling episodes. For the trial, a lead is positioned along side the sacral nerve and connected to an external battery. You’ll monitor your symptoms to see how well the treatment is working.

If you have at least 50% improvement during the trial, you will probably be a good permanent implant candidate. Usually, the final device placement procedure is performed in an outpatient setting and lasts less than one hour. The device is implanted under the skin, near your upper buttock or lower back, and the leads are connected to the sacral nerves.

What Results Can You Expect?

“Robotic-assisted SNS has been a ‘game changer’ for many patients with fecal soiling and incontinence. Clinical trials indicate that more than 90% of individuals who respond favorably during the trial period report continued improvements after permanent implantation. Most of the patients are able to get back to their regular lives, play sports, socialize and work in public without worrying of leak and embarrassment.

The stimulation is a simple tapping or pulsing sensation. It doesn’t hurt, and they eventually forget the device is in place. You’ll also get a small hand-held remote that allows you to tweak the intensity and settings as desired. Follow-up exams are generally needed infrequently or never, and in your provider’s office, you can make adjustments to release fluid buildup.

Why is this better than older techniques like the Thiersch procedure?

In the past, surgical techniques, such as the Thiersch procedure, were employed to treat fecal incontinence through the physical contraction of the anal opening with a synthetic ring or mesh. But these techniques didn’t treat the underlying nerve dysfunction. They tended to come with complications like erosion, infection or constipation. Well-intentioned though they may have been, they addressed the symptom, but not the cause.

SNS, however, treats the functional problem. It not only covers up symptoms of fecal soiling, it actually aims to reset the system that is failing. It’s also far more pleasant and sustainable in the long run.

Is SNS Safe? What Are the Risks?

As with any surgery, SNS does come with risks — though they are typically low. Minor infections or irritations around the implant area can occur in some patients. Others may simply require a repositioning or readingjustment of the device. The good news is SNS is reversible — if this approach doesn’t work or doesn’t feel right for you, you can have it turned off or removed altogether. That makes it a much safer alternative to other invasive and permanent surgeries.

Most patients with SNS can be known to lead a relatively unhindered life. Air travel, exercise and even MRIs (with precautions) are generally fine, depending on the device. Within 1 week after device implantation, most patients resume full activity.

What If SNS Isn’t For Me?

Santa Navigabilia via Medical Devices (Animated GIF) Not everyone is going to be perfect when it comes to needing sacral nerve stimulation. In such cases, nonsurgical treatments may involve either sphincter repair procedure, injectable bulking agents, or bowel retraining management programs. In extreme cases, the surgeon would consider a colostomy. But SNS is now often attempted before invasive or irreversible alternatives because of its safety, its success rate and its convenience.

Conclusion

Fixing fecal soiling is not only doable — it’s often totally doable with the right treatment. Besides, treatments like sacral nerve stimulation represent real hope for those who suffer from this condition and have tried other treatments to no avail. Given the high rate of success, the minimal risks, and the convenience of having control returned, SNS is an intelligent and progressive solution for achieving dignity and daily comfort. If you’re ready to take back your life, have a conversation with a specialist and see if SNS is the next step for you.