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Have severely torn rectal sphincter, IBS, weight loss. On physical therapy. Help?

I have had a problem with a severly torn rectal sphincter since my too large to deliver son in 1978. In 2001 there was an attempt tp repair ir. It failed and I have been caught in uncontrolable episode of involuntay fecal incontenence most ooften if stool was loose (not watery) but even pasty. I have been through the Physicak Therapy for woman to build that sphincter mucscle with minimal shot term help. But for quite a while I loose control of my bowel. It especially happens if I have not eaten much during the day or after a normal (not large) meal I consider as the largest one of the day. Stools vary from sometime normal most ofter pasty and still uncontroled. Within an hour or less after eating gas pain begins and no mater how bland the food it suddenly begin watery and contain a lot of mucous. It is debilitayin and I am afraid to go out with protection which sometimes may still not be enough. I am 64 years old now but this is not a new problem. My primary care treats for IBS due to some high stress in my immediate family abd the rest is blamed on the sphincter. But this is often explosive and can t be controled any more than projectile vomiting. I have been over weigh and am loosing weight well now but I tested myself to be sure the weight loss was voluntary. I added a few pounds and returned to watching my weight. I isn t whre it needs to be but 15 plus more pounds will be great. In 2010 I weight 191 which seemed to come on during some aniety eating. I know a colonoscopy needs to be dome and is in fact being set up. Could you shed any insight on what may be the cause of this problem. The only blood I ever see is very occassional and can find the internal hemmorrhoid usually happing after frequent loose stools irritation it.
Asked On : Wed, 20 Mar 2013
Answers:  1 Views:  60
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General & Family Physician 's  Response
You say that you had torn rectal sprinter in 1978. Once torn is diagnosed it should have been meticulously sutured, regular follow up and pelvic floor exercises
Now after these long years the sphincter and muscle might have lost its elasticity and tone, but no harm to repair it with latest techniques. Avoiding constipation is the main point for torn sphincter. Where as you say that you are suffering from IBS and you have incontinence of motion and diarrhea. I think with pelvic floor exercises you can find some relief for incontinence. Consulting a dietitian a balanced diet not producing diarrhea or constipation may be of some help for your complaints.
Meanwhile You say that you have internal piles coming out after loose stools, means that you have to assess the degree of damage (torn) to the sphinters.
I expect a minimum damage to the sphincter.
Consult an Ano Rectal surgeon and plan your future treatment.
Best wishes
Answered: Sat, 27 Jul 2013
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