Fecal Incontinence

Diagnosis & Tests

If you are having trouble controlling your bowels, tell your healthcare provider, who can help you. Your healthcare provider will ask you questions, such as how often and when you lose control of your bowels. Your provider will also examine you to check for hemorrhoids and other conditions leading to fecal incontinence. If necessary, you may be referred to a specialist, such as a gastroenterologist, proctologist, or colorectal surgeon. A specialist may use one or more of the following tests to evaluate you further:

  • Sigmoidoscopy.  A test in which the specialist inserts a flexible tube fitted with a camera-like device into the rectum.  It can be used to look for problems such as tumors, inflammation, and scar tissue that may contribute to fecal incontinence. 
  • Anal manometry. During this test, the specialist uses a pressure-sensitive tube to check how tightly the sphincter muscles in your rectum close, and how well they respond to signals from your nerves. 
  • Endorectal ultrasound. A test where a probe is inserted into the rectum and high-frequency sound waves (ultrasound waves) are created. The pattern of echoes as they bounce off tissues is turned into a picture (sonogram), to look for problems in the deeper tissues that are not visible on a camera. 
  • Anal electromyography. A test where tiny needle electrodes are used to test the muscles for scar tissue in the pelvic floor and rectal sphincters. This scar tissue can contribute to fecal incontinence.  
  • Proctography (also known as defecography). A special x-ray video test where liquid barium is placed into your rectum using a small tube.  It shows how much stool your rectum can hold and also how well it empties when you use a special toilet.

It is important to note that these procedures and tests may not be appropriate for all individuals. This is especially the case for those with moderate to severe dementia as they require complete cooperation by the older adult. A lot of information can be obtained through a routine history and physical examination by a trained specialist without these specialized tests.

Last Updated July 2020