Tag Archives: Bowel Incontinence Treatment Options

Physical Therapy for Fecal Incontinence

Bowel control problems may be reduced through frequent physical therapy. In some cases, bowel incontinence or leaks are caused by the improper alignment of the pelvic or spine bones and joints. This leads to muscle spasms, weakness, and ultimately bowel or urinary incontinence.

Anismus, or dyssynergic defecation, is when the pelvic floor muscles fail to relax or maintain coordination during the passage of stool. Physical therapy, along with dietary modification, can help the pelvic muscles relax, aiding in the proper passage of stool through the lower intestine and out the rectum.

Biofeedback is a safe, noninvasive, and effective treatment method. During biofeedback, you will learn how to retrain your bowel muscles. Through the use of small sensors attached on the outside of the body, you will learn when to contract the anal sphincter muscles.

Bowel training is another form of physical therapy that involves creating a bathroom schedule with your physician. This form of behavioral therapy will help you establish and maintain control of your bowel habits.

Take our Fecal Incontinence Self-Assessment

Medication for Urinary and Fecal Incontinence

You’ve cut out soda and spicy food. Your working on your Kegel exercises. But incontinence is still a problem. When behavioral and diet changes aren’t enough, urinary and fecal incontinence can be treated with medication.

Before taking any medication for incontinence, it is important to speak to a physician. Certain medications can be a dangerous mask for a larger problem. Over-the-counter medications such as antacids and laxatives may, in fact, be making your bladder or bowel issues far worse. Consequently, if you are taking unrelated prescription medications, these could be irritating your bladder or bowel.

Fortunately, there are many forms of treatment for urinary and fecal incontinence including oral medications, patches, or creams.

What are common medications for Urinary Incontinence?

Common medications to treat bladder control problems include anticholinergics, mirabegron, topical estrogen, and alpha blockers.


Anticholinergics are used to treat overactive bladder. They work by blocking the chemical messenger acetylcholine that sends the signal that you need to urinate to the brain.


Mirabegron is used to relax bladder muscles so that the bladder can hold more urine. Additionally, it increases the amount that you can urinate, allowing you to empty your bladder more completely.

Topical estrogen

Women with incontinence may be prescribed a low-dose topical estrogen in the form of a ring or cream. This topical estrogen helps tone tissues and eliminate vaginal dryness.

Alpha blockers

Alpha blockers help men with urge and overflow incontinence due to prostate enlargement. They relax muscles to reduce a sense of urgency and improve urine flow, making it easier to fully empty the bladder. Some examples of Alpha blockers include Rapaflo, Cardura, and Flomax.

What are common medications for Bowel Incontinence?

Anti-diarrheal medication

When bowel incontinence is caused by loose stool, anti-diarrheal medication may be prescribed to help solidify stool.


Metamucil is a fiber supplement that is typically used as a stool bulking agent. Bulking agents absorb water to make stool firmer and reduce leakage.

Before taking any medication to treat incontinence, it is important to speak to a physician. Taking the wrong medication can actually aggravate your incontinence, so it’s important to properly diagnose.

The expert physicians at Incontinence Institute can help you pinpoint the source of your incontinence and determine the best method of treatment. Determining the source of your urinary or fecal incontinence symptoms will allow your physician a better understanding of your condition and how it can be effectively treated.

Contact the Incontinence Institute today to schedule a consultation.

InterStim Implants for Urinary or Bowel Incontinence

Incontinence is often the result of a miscommunication between the brain and the bladder and/or bowels. InterStim therapy, a type of sacral neuromodulation (SNM) or sacral nerve stimulation (SNS) therapy, works to re-establish this very important communication channel. Incontinence Institute offers three implanted sacral neuromodulation devices: 

  1. InterStim II
  2. InterStim Micro
  3. Axonics

How does InterStim therapy work?

InterStim therapy works by stimulating the sacral nerves with tiny electrical pulses. In individuals experiencing urinary or fecal incontinence, the brain and the sacral nerves are unable to communicate properly. InterStim therapy attempts to better regulate the sacral nerves’ function, so the nerves can interpret signals from the brain and pass them on to the surrounding pelvic floor muscles. Mild electrical pulses help the nerves to function normally, much in the same way that a pacemaker uses electrical impulses to keep the heart beating on a steady, predictable rhythm. This restores normal bladder and bowel function.

As a result of the pulses from InterStim devices, the symptoms of an overactive bladder or bowel incontinence are effectively eliminated. 

These devices are an option for patients who have not responded to more conservative treatments such as changes to diet, medication and physical therapy.

What’s the process for getting an InterStim device?

Stage 1, trial period and evaluation:  InterStim therapy begins with a two-week trial period employing a wearable, external version of the device to determine if the treatment is likely to be effective for a patient. This is known as InterStim Stage 1. 

Stage 2, surgery: If the trial produces positive results, the device is implanted in a patient’s lower back near the sacral nerves. Surgery is known as InterStim Stage 2.

Post-surgery: After surgery to implant an InterStim device, the doctor will program the device’s electrical signals based on the results from the trial period. 

InterStim Therapy Trial Period

InterStim II and InterStim Micro offer a trial device that simulates the actual, implanted device. This is called InterStim Stage 1. Receiving the trial device is a 15-minute, minimally invasive outpatient procedure where the doctor places a lead connected to a small, externally worn device. The external device is worn underneath the patient’s clothing. 

Patients typically wear the trial device between 5-14 days to determine candidacy for a permanent device. During this time, patients log their symptoms to discuss with their doctors. They can continue about their normal activities and experience what it would be like to live with InterStim therapy, how it feels when activated, and if the permanent device will be able to reduce or eliminate their symptoms.

How is an InterStim device implanted?

InterStim placement is quickly and safely done at an outpatient surgery center. The procedure itself typically takes between 20-30 minutes to complete, and surgery is minimally invasive. This can often be done under local anesthesia, though some doctors will prefer to use general anesthesia. The device is inserted in the lower back, above the buttocks. 

Though insurance plans vary, Medicare and private insurance generally cover InterStim treatment, but please consult with your doctor and insurance company.

How long does it take to recover from surgery?

Patients typically return to their normal activities within three weeks following the InterStim procedure. Light activity is usually possible within a few days after surgery. 

What to Expect After the Device is Implanted

Most patients will notice a slight pulling or tingling sensation, according to Medtronic, which manufactures the InterStim devices. These sensations should not be painful — if they are, contact your doctor. Sudden movement can also cause a change in how the stimulation feels, because the device shifted in proximity to your sacral nerve. This doesn’t affect the effectiveness of the stimulation has changed. After a few weeks, patients typically report they don’t notice the sensation anymore. 

The goal is for InterStim therapy to help patients return to their daily routines without worrying about bowel or urinary incontinence. A successful procedure should help patients be more confident of their ability to go through life, taking long walks, traveling or visiting a movie theater. Things that were difficult become possible, once patients are no longer worried about incontinence. 

How do I program or manage an InterStim device?

Both InterStim devices come with a hand-held programming remote that allows patients to turn down or turn off the InterStim device if needed. Your doctor may also program the device to turn on and off at regular intervals, depending on whether you need constant stimulation. 

Will I be able to see the InterStim device through my skin?

No, you will not be able to see InterStim II or InterStim Micro devices through the skin once they’re implanted. 

Can the InterStim device be removed?

Yes, the device can be removed. In the unlikely event that the procedure is not effective, it can easily be reversed. Both devices eventually need to be removed and replaced; the recharge-free InterStim II needs to be replaced every 5 years, and the rechargeable InterStim Micro needs to be replaced every 15 years.

Can I have an MRI with an InterStim device?

Yes, InterStim devices are full-body MRI compatible. Please talk to your doctor for more details.

What are the differences between Axonics, InterStim II and InterStim Micro?

InterStim II

  • About the size of a silver dollar, 44mm x 51 mm
  • Doesn’t require recharging
  • Needs to be replaced about every five years

InterStim Micro

  • Smallest SNM device available, 17 mm x 47 mm
  • Requires charging for 20 minutes, once a week
  • Needs to be replaced about every 15 years

Axonics Therapy

  • About the size of a quarter, 23 mm x 45 mm
  • Requires wireless charging for about an hour, once a month
  • Needs to be replaced about every 15 years

InterStim Therapy for Urinary Incontinence

Urinary incontinence affects over 25 million Americans. A number of causes exist: injury or trauma to the pelvic region or back, enlarged prostate or prostate cancer, pregnancy or childbirth, neurological disorders, estrogen loss following menopause, other health conditions like multiple sclerosis or suffering a stroke. 

Take our Urinary Incontinence Self-Assessment

Effectiveness of InterStim Devices for Urinary Incontinence

According to studies in the Journal of Urology and Medtronic’s own InterStim Therapy Clinical Summary, 82% of overactive bladder (OAB) patients achieved therapeutic success with an InterStim device at five years of treatment. 

  • 59% of urge incontinent patients achieved greater than 50% reduction in leaks/day
    • 71% of those urge incontinent patients who reported heavy leaks at baseline achieved greater than 50% reduction in leaks/day
  • 45% of patients had no incontinence episodes at five years of treatment
  • 56% of urgency-frequency patients achieved greater than 50% increase in volume voided and improved degree of urgency

InterStim Therapy for Fecal Incontinence

According to a report from the University of Rochester, bowel incontinence affects as many as 18 million Americans. Aging or injuries incurred while giving birth are the most common causes for fecal incontinence. 

Take our Fecal Incontinence Self-Assessment

Effectiveness of InterStim Devices for Bowel Incontinence

In study results published in the medical journal “Annals of Surgery,” 120 patients and their doctors tracked the effectiveness of the therapy. 

  • About half of the patients experienced total recovery of bowel control and reported no incontinence problems for one year after the surgery 
  • 30% reported that their bowel leaks were reduced by more than 50%
  • InterStim therapy produced significant positive results for more than 8 out of 10 patients 

InterStim Therapy History

InterStim devices have been used to prevent urinary incontinence since 1997. In 2011, after extensive study, the Food and Drug Administration (FDA) also approved the use of the InterStim implant as a fecal incontinence treatment. Over 100,000 individuals have been treated with InterStim therapy.

Who is a good candidate for InterStim therapy?

InterStim can be a great option for patients who haven’t experienced success with treatments like supplements and dietary adjustments. Ideal candidates are men and women suffering from these conditions:

  • Overactive bladder
  • Urinary or bowel urge incontinence
  • Urgency-frequency
  • Non-obstructive urinary retention
  • Chronic fecal incontinence

But it’s not a good option for all patients, including patients who:

  • Lack the motor skills needed to operate the InterStim system
  • Are not good candidates for surgery
  • Suffer primarily from stress incontinence
  • Experience urinary retention due to benign prostatic hypertrophy (enlarged prostate)
  • Have cancer or urethral stricture

InterStim therapy may also not be a good option for patients who are pregnant, are under the age of 16 or who have neurological issues as a result of a chronic condition such as diabetes or multiple sclerosis, since the safety and effectiveness of the treatment has not been established in these populations.

If you’ve tried conservative approaches for your urinary or fecal incontinence and your symptoms still interfere with your daily activities, InterStim could be right for you. Contact our team of expert urinary and fecal incontinence doctors at our office in Nashville, TN.

Hemorrhoid Banding Treatment

Hemorrhoids are swollen veins in the anal canal that can form internally or externally. These swollen groups of veins can be very painful and even embarrassing. But hemorrhoids are common and affect millions of men and women.

During a bowel movement, sensitive tissues inside the anus fill with blood. The strain of a bowel movement puts pressure on this tissue, making the veins swell and eventually forming hemorrhoids.

Common symptoms of hemorrhoids include:

  • Itching
  • Rectal pain
  • Blood on toilet tissue or in your stool

Hemorrhoids typically accompany bowel incontinence and can be very painful. As a result of increased pressure on their pelvic regions, pregnant women and overweight individuals are more likely to develop hemorrhoids. Depending on the severity of the hemorrhoids, hemorrhoid banding may be recommended.

Hemorrhoid banding is a treatment option for the development of severe internal, and in some cases, external hemorrhoids. During the hemorrhoid banding procedure, the hemorrhoid is tied off by a small rubberized material, which is essentially a clinical-grade rubber band.

When performed successfully, this procedure discontinues the blood supply to the hemorrhoid, causing it to shrink and eventually die. Scar tissue develops in place of the old hemorrhoid, strengthening the area and ultimately decreasing the likelihood that a new hemorrhoid will form. Hemorrhoid banding is a common, outpatient procedure with a fast recovery rate of about seven to ten days.

Take our Fecal Incontinence Self-Assessment

Dietary Modification

Changing your lifestyle is an important first step when suffering from bowel control issues or bowel incontinence. Dietary modification is typically the first attempt at treatment – it is noninvasive and easy to try at home. It’s possible that your bowel incontinence may be the result of a food allergy in your intestines.

A good first step is to write down every food and drink you are consuming, and when you have a bowel movement, an urge, a leak, or any other symptom. This can help you identify foods that trigger your bowel symptoms. Try to eliminate those foods or drinks (because it could be something like coffee) and see how you feel.

Slowly adding suspected negative foods back into your diet and experiencing the same symptoms will confirm that your body is not responding well. Spend a month or more documenting your foods and see how you feel.

If you are really not sure what foods are irritating your bowel symptoms, try avoiding these foods and drinks that are known to contribute to bowel control issues:

  • Alcohol
  • Caffeine
  • Dairy products
  • Chocolate
  • Spicy foods
  • Cured meats
  • Greasy and fried foods
  • Artificial sweeteners
  • Citrus fruits

About The Incontinence Institute

At the Incontinence Institute, our team of healthcare providers understand the physical and mental trials that accompany living with urinary or bowel incontinence. Because of this, we are sensitive to your situation and treat all of our patients with the utmost respect and concern for discretion.

Individual incontinence conditions, treatment and recovery times may vary. Each patient's experience with incontinence procedures and / or surgery will differ. All surgical procedures involve some level of risk. If directed to pursue surgery by your physician, prompt action is advised, as waiting may reduce the efficacy of surgical treatment. The opinions expressed in patient testimonials are by patients only; they are not qualified medical professionals. These opinions should not be relied upon as, or in place of, the medical advice of a licensed doctor, etc.

Contact Us

Incontinence Institute 2009 Mallory Lane, Suite 100 Franklin, Tennessee 37067