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Re: Weak Sphincter cause of fecal incontinence?

Posted By Worried  on July 03, 1999 at 10:02:24
I appreciate you taking the time to read this and perhaps offer some insight.  I am a 33 year old female with the beginnings of fecal incontinence and also sever stomach pain (spasms).  A little background:  Almost 1 year ago I started having chronic UTIs and a Urologist found that I was retaining urine.  Was put on self cath 3 times perday, and bladder problems quickly got worse.  For the last 9 months or so, i have had a completely non functioning bladder.  had other symptoms ie.  severe headaches and migraines, some dizzyness and unsteadiness, periodic numbness in left thingh, hot shooting pains at back of neck, etc.  Was sent to Mayo Scottsdale.  Urologist and Neurologist did complete exams and testing and found no MS.  diagnosed with fibromyalgia and a non functioning bladder, I have no feeling of fullness until 1400 cc's full, and am unable to urinate through the uretha at all.    Continued with chronic UTIs and some kidney infections while having a supra pubic cath, and then back to self cathing for last 4 months (about 8 xs per day).  Infections are very stubborn and it takes between 2-5 rounds of oral antibiotics and sometimes IVs and injections for the infections to clear up.
About 3 months ago, I started having trouble controlling my bowels.  No feeling of fullness whatsoever and I have accidents now 1-2 times per week.  GI Doc did a rectal and said the sphincter is very very weak and he thinks this is the cause of my problems.  He is trying to order a "baloon test" if my insurance will authorize it, but said he's almost positive thats my problem.  Meanwhile, I have sever stomach pain.  Pain is just under my navel, but almost the length of my abdomen.  i also have a lot of pain in center of lower back nad in bottom right and left pelvic area.  Had abdominal cat scan about  2 weeks ago which found nothing.  I apologize for this being so long, but I am very worried, and didnt want to leave anything out.  My GI Doctor was in a hurry to finish our appointemnt, and when i asked if a sphincter can be fixed, all he said was it depends.  My questions are as follows:
1.  Could a very weak sphincter cause my fecal incontinence?
    If so, can a sphincter be fixed?  How..ie. surgery, and what     is involved.
2.  I was excited to hear that my problems could be related to     something so minor, but now I am wondering.. doesnt there     have to be a cause for the weakness?  I am hoping this still     isnt MS, could it just happen on it's own?  Any ideas what     this might be?
3.  As far as the pain goes, could a weak sphincter be causing     this?  Dr. said it could be spasms.  ny idea what might help     with the pain?  I am taking reglan, metamucil, vicodin, and     tylenol 3.  
Thank you so much for any answers and suggestions you can give me, your forum is greatly appreciated.

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Posted By HFHSM.D.-Gastro-RF on July 11, 1999 at 10:42:19
Dear Worried,
A weak anal sphincter can result from either injury to the sphincter muscle ( as  may occur with vaginal deliveries or from rectal surgery e.g. treament of refractory fissure) or damage to the muscle innervating the sphincter.  The problems with bowel and bladder would suggest a nerve problem as opposed to a primary problem of the rectal sphincter muscle.
A weak sphincter can cause fecal incontinence.  
As a first step, you should try to increase the bulk of your stool by using fiber, as suggested by Laurie.  Exercies to increase the muscle tone of the external sphincer are worth the effort.  Biofeedback can retrain the sphincters in some circumstances.
This information is presented for educational purposes only.  Ask specific questions to your personal physician.  If you wish a second opinion, we would be happy to see you at the Division of Gastroenterology of Henry Ford Health System.  You can make an appoinment with Dr. Fogel, one of our experts in the treatment of diarrhea, by calling our Physician Referral Line at (800)653-6568
*keywords: incontinence, anal sphincter, biofeedback

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Weak Sphincter cause of fecal incontinence? Worried 7/12/1999

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