Fecal Incontinence

You’ll see a gastroenterologist or a colorectal surgeon, specialists trained to help you. Your healthcare provider will ask you questions about your symptoms and do a physical exam and a rectal exam. Don’t be embarrassed to talk freely about the issues you’re having.

Tests

You may need the following tests to find what’s causing the leakage:

• Anorectal manometry: This test studies the strength of your anal sphincter muscles, including how effectively they coordinate with your rectum to control bowel movements.
• Balloon expulsion test: You may take this test alongside anorectal manometry, especially if your provider suspects chronic constipation may be causing your incontinence. It also tests how well your anal sphincter muscles and rectum are working to pass stool.
• Endorectal ultrasound or MRI: These tests help your provider check the structure of your anal sphincter muscles and surrounding tissue. They can show tissue damage or abnormalities related to incontinence.
• Pudendal nerve terminal motor latency test: This test measures how well your pudendal nerve (the nerve that controls your anal sphincter) is working.
• Anal sphincter electromyography (EMG): This test determines if nerve damage is why your anal sphincter muscles aren’t working properly. It also examines the coordination between your rectum and anal muscles.
• Defecography: This test takes X-ray or MRI images to see how your organs and muscles work when you’re holding and releasing stool.
• Endoscopy: This test uses a scope with a camera to check for abnormalities in your lower digestive system (inflammation, a tumor or scar tissue) that may cause fecal incontinence. A flexible sigmoidoscopy and colonoscopy check your colon (large intestine). A proctoscopy checks your rectum and anus. And an anoscopy checks your anus.

You may need a blood test or stool test to check for causes of frequent diarrhea, like infection-causing microbes (bacteria, viruses and parasites).