Incontinence

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What is incontinence and how does it occur?
Bowel incontinence, also known as fecal incontinence (FI), prevents individuals from controlling their bowel movements and affects an estimated 8.3 percent of U.S. adults, primarily women. Patients experience unexpected leaks, or use the bathroom very frequently. Some people may suffer from fecal incontinence due to not being able to sense a bowel movement, while others are able to sense a bowel movement but can’t hold it until they get to a bathroom.

Causes
Fecal incontinence is usually an acquired disorder. It is typically caused by obstetrical injury from pregnancy or childbirth but may also be caused by:

  • Stroke or advanced age
  • Nerve or muscular damage caused by surgery or injury
  • Conditions that affect the nerves, such as diabetes, Parkinson’s disease, and multiple sclerosis
  • Inflammatory bowel disease and irritable bowel syndrome
  • Congenital disorders

Dr. Coppola, MD

About Dr. Coppola
Dr. Coppola is Board Certified in Gastroenterology by the ABIM. He practices General Gastroenterology and specializes in Incontinence Therapy, Obesity Medicine and is the leading physician in the state performing Advanced Biliary Endoscopy. He has been in Private Practice in Little Rock for 15 years.

Fecal Incontinence Treatment
Diet changes
Treatment for fecal incontinence starts with behavioral therapy. Dietary changes include: low residue diet (the restriction of insoluble fiber and other foods that are harder for your body to digest); avoiding flatus producing foods; Fiber supplementation is also useful for incontinence of liquid or loose stool as it is soluoble fiber that absorbs liquid and bulks the stool.

Medication
Other therapy includes medications which affect colonic motility (movement) like loperamide (Imodium) or Lomotil which constipates or hardens the stool.

Surgery
Options for surgical repairs have historically been limited with success rates ranging from six to 10 percent at 10 years. Due to these low success rates there has been an investigation for better treatments.

How does InterStim evaluation work?
The evaluation lets you try Medtronic InterStim Therapy to see if it’s right for you without making a commitment to permanent placement. The evaluation will take approximately 7 days to complete. Under moderate sedation in an outpatient procedure, your doctor will implant a thin, flexible wire near your tailbone. The wire is taped to your skin and connected to a small external device which you’ll wear on your waistband. The external device sends mild electrical pulse through the wire to nerves near your tailbone. We will contact you throughout the trial to assist you in adjusting the stimulation to your needs and control. After a week you return to our office and we remove the trial device.

What is the next step?
If your Trial is successful you will be referred for permanent placement.

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