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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Fecal Incontinence?

My daughter has been having accidents for the past four years, mostly stool. We have seen her pediatrician many times, seen a pediatric nephrologist, a pediatric gastroenterologist and had x-rays, ultrasounds, KUB, and tried mess. She is currently on Miralax but continues to have two to three accidents a day. She also is seeing a therapist but that hasn't helped either. We have tried numerous behavioral approaches and nothing helps. Any advice please?
Mon, 28 Aug 2017
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General Surgeon 's  Response
Hi.
Thanks for your query.
Noted the history and understood your concerns.
Your daughter having fecal accidents incontinence with accidents can be due to the following reasons.
First of all, Miralax it self can cause uncontrolled diarrhea and thus the fecal accidents, it is wonderful to know why is it continued orf started in the first place; stop this immediately.
Second reason can be excessive mucus formation and thus causing passage or gas and stool easily even on slightest of straining.
Any neurological cause that has weakened the anal sphincters.
Since you have already consulted Pediatric Nephrologist, Gastroenterologist, and had had X-rays, ultrasound and all the things that you have mentioned.
Hence I would advise you the following:
First of all consult a Pediatric Surgeon.
Get per-rectal digital examination to know whether the tone of muscles and sphincters around anus normal or not.
Get an MRI of the lower spine as this may show a cause if neurological cause is found.
Get the stool and blood tests done.
IF there is any abnormality, get this treated.
Pediatric colonoscopy may be of tremendous help.
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How To Treat Fecal Incontinence?

Hi. Thanks for your query. Noted the history and understood your concerns. Your daughter having fecal accidents incontinence with accidents can be due to the following reasons. First of all, Miralax it self can cause uncontrolled diarrhea and thus the fecal accidents, it is wonderful to know why is it continued orf started in the first place; stop this immediately. Second reason can be excessive mucus formation and thus causing passage or gas and stool easily even on slightest of straining. Any neurological cause that has weakened the anal sphincters. Since you have already consulted Pediatric Nephrologist, Gastroenterologist, and had had X-rays, ultrasound and all the things that you have mentioned. Hence I would advise you the following: First of all consult a Pediatric Surgeon. Get per-rectal digital examination to know whether the tone of muscles and sphincters around anus normal or not. Get an MRI of the lower spine as this may show a cause if neurological cause is found. Get the stool and blood tests done. IF there is any abnormality, get this treated. Pediatric colonoscopy may be of tremendous help.