Bowel incontinence Health Article

Call your health care provider if

• There is any incontinence of stool in a child that has been previously toilet trained
• There is any incontinence of stool in an adult
• There is any skin irritation or ulceration as a result of bowel incontinence

What to expect at your health care provider's office

The health care provider will perform a physical examination, focusing on the stomach area and rectum. A finger exam of the rectum and anus will be performed. The health care provider will insert a lubricated finger into the rectum to evaluate sphincter tone, anal reflexes, and check for any abnormalities of the rectal area.

Medical history questions documenting bowel incontinence in detail may include:

• Has anything happened recently to cause emotional upset?
• Is the patient confused or disoriented?
• In a child, was he or she previously toilet trained? Did he or she have trouble with toilet training?
• What other symptoms are also present?
• Describe your problem. When does this occur?
• How long has incontinence been a problem?
• How many times does this happen each day?
• Are you aware of the need to defecate before you leak?
• What is the consistency of the stool? Is it hard, soft, liquid?
• Describe the amount of stool leakage (discharge, with gas, large amount of stool)?
• What surgeries have you had?
• What injuries have you had?
• What medications do you take?
• Do you drink coffee? How much?
• Do you drink alcohol? How much?
• Describe your usual diet.

Diagnostic tests may include:

• Stool culture if person has chronic diarrhea
• Blood tests
• Barium enema
• Defecography (X-ray procedure using a special dye to visualize the bowel while the person defecates)
• Balloon sphincterogram (X-ray procedure using a special dye to evaluate how well the sphincter contracts)
• Anal manometry (measures anal sphincter tone)
• Rectal or pelvic ultrasound
• EMG