Fecal Incontinence

What it is

Fecal incontinence is the involuntary loss of stool or gas, with a profound impact on self-esteem, social life and intimacy. It is more common in women, especially after vaginal deliveries with tears or forceps use, and during menopause, but it can also result from anal surgery, neurological conditions, chronic diarrhea or fecal impaction. Many women live with the problem for years without talking about it. At Femi Saúde, the coloproctology team approaches the topic with discretion and warmth, investigates the cause with a physical exam and functional tests, and proposes a staged treatment, ranging from dietary adjustments and medication to biofeedback physical therapy and, in selected cases, sphincter repair procedures or surgery.

Most common symptoms

• Involuntary loss of stool or gas
• Urgency and difficulty holding on until reaching the bathroom
• Unnoticed leakage of stool
• Frequent soiling of underwear
• Irritation and itching of the perianal skin
• Restricting activities for fear of leakage

Causes and risk factors

• Sphincter injury during childbirth
• Previous anal surgery
• Muscle weakening with age and menopause
• Chronic diarrhea or fecal impaction
• Neurological conditions and diabetes
• Rectal prolapse

How it is diagnosed

The evaluation begins with a conversation about the frequency, type of leakage and impact on daily life, along with the obstetric and surgical history. The physical exam with a digital rectal exam assesses sphincter tone and contraction. Anorectal manometry measures rectal pressure and sensitivity, and endoanal ultrasound identifies muscle injuries, which are common after childbirth. When bowel disease or rectal lesions are suspected, colonoscopy complements the investigation. The coloproctologist conducts it all with privacy and without rushing.

How we treat it at Femi Saúde

Treatment is stepwise. It starts with regularizing stool, using fiber, dietary adjustments and medications that reduce diarrhea or treat impaction, along with pelvic floor physical therapy with biofeedback, which strengthens and coordinates the sphincter. When this isn't enough, the coloproctology team at Femi Saúde may recommend procedures such as sacral nerve neuromodulation, bulking agents or, for well-defined muscle injuries, sphincter repair surgery. Skin care and practical day-to-day strategies are part of the plan at every stage.

What we offer