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BOWEL CONDITIONS

If you are suffering from bowel conditions such as incontinence or Irritable Bowel Syndrome you are not alone.  These and other bowel conditions are more common than you might think – but many people suffer in silence for weeks or months before talking to their doctor about the problem.

Many times treating bowel conditions can be as simple as changing diet, adding a medication, a convenient injection or even at home treatments.

So don’t wait to call CRS about a bowel condition.  We can diagnose the problem and provide a treatment plan so you can get relief – and get your life back.  Read more about what causes common bowel conditions like bowel incontinence and IBS.


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Bowel Incontinence

You can win against loss of control.

Loss of bowel control is embarrassing and those who suffer from it are tired of sacrificing fun.  But you don’t have to.  Our non-invasive diagnostic tool helps us find the root cause so we can develop a more effective treatment for you.  And you can get your life back.

Easy Treatment Options
Not everyone experiencing bowel or fecal incontinence will need surgery.  There are many convenient treatment options that can provide relief and are virtually pain-free.

One option includes InToneMV, a non-invasive tool that can be used in the privacy of your own home. InToneMV combines a customizable probe with muscle stimulation to effectively strengthen the muscles of the pelvic floor, helping you maintain continence.

InToneMV
InToneMV

InToneMV provides voice-guided exercises and visual biofeedback to help you complete the series of  exercises.  Data from each home-based session is recorded and your CRS physician can review during follow-up visits to maximize your progress.

What is bowel incontinence?
Bowel incontinence, sometimes also referred to as fecal incontinence, is the impaired ability to control gas or stool and affects men and women.  Severity ranges from mild difficulty with gas control to severe loss of control over liquid and formed stools. Bowel incontinence is a common problem, but often it is not discussed due to embarrassment.

What causes incontinence?
Both bladder and bowel incontinence tend to increase with age, but there are many causes of incontinence.  Injury during childbirth is one of the most common causes. These injuries may cause a separation in the anal muscles and decrease in muscle strength. The nerves supplying the anal muscles may also be injured. While some injuries may be recognized immediately following childbirth, many others may go unnoticed and not become a problem until later in life. In these situations, past childbirth may not be recognized as the cause of incontinence.

Anal operations or injury to the tissue surrounding the anal region similarly can damage the anal muscles and hinder bowel control. Infections around the anal area may destroy muscle tissue leading to problems of incontinence. In addition, as people age, they experience loss of strength in the anal muscles. As a result, a minor problem in a younger person may become more significant later in life.

Diarrhea may be associated with a feeling of urgency or stool leakage due to the frequent liquid stools passing through the anal opening. If bleeding accompanies lack of bowel control, consult your CRS physician. These symptoms may indicate inflammation within the colon (colitis), a rectal tumor, or rectal prolapse – all conditions that require prompt evaluation by a physician.

How is the cause of incontinence determined?
First you need to discuss the problem with your physician to  establish the severity and the impact it has on your lifestyle.

Many clues to the origin of incontinence may be found in patient histories.  For example, a woman’s history of past childbirths is very important.  Multiple pregnancies, large weight babies, forceps deliveries, or episiotomies may contribute to muscle or nerve injury during childbirth.  In some cases, medical illnesses and medications play a role in problems with control.

A physical exam of the anal region should be performed and may readily identify an obvious injury to the anal muscles.  In other cases additional tests may be required.

Tests
Our Pelvic Floor Lab is a non-invasive diagnostic tool that allows us to pinpoint the issue so we can create an effective treatment plan.

Tests may include manometry, where a small catheter is placed into the anus to record pressure as patients relax and tighten the anal muscles. This test can demonstrate how weak or strong the muscle really is.

A separate test may also be conducted to determine if the nerves that go to the anal muscles are functioning properly. In addition, an ultrasound probe can be used within the anal area to provide a picture of the muscles and show areas in which the anal muscles have been injured.

What can be done to correct the problem?
After a careful history, physical examination and testing to determine the cause and severity of the problem and treatment can be addressed.  Mild problems may be treated very simply with dietary changes and the use of some constipating medications. Your physician also may recommend simple home exercises that may strengthen the anal muscles to help in mild cases.

In other cases, biofeedback can be used to help patients sense when stool is ready to be evacuated and help strengthen the muscles.

Other injuries to the anal muscles may be repaired with surgery.

Diseases which cause inflammation in the rectum, such as colitis, may contribute to anal control problems. Treating these diseases also may eliminate or improve symptoms of incontinence. Sometimes a change in prescribed medications may help.

In the past, patients with no hope of regaining bowel control required a colostomy. Today, this procedure is rarely required. In addition, current search into the development of an artificial anal muscle may soon find a place in treating patients with difficult control problems.


Irritable Bowel Syndrome

What is Irritable Bowel Syndrome?
Irritable bowel syndrome (IBS) is a common disorder that may affect up to 30 percent of all Americans at some time during their lives. The disorder has many names, including nervous colon, spastic colon, spastic bowel, mucous colitis and spastic colitis. However, it should not be confused with diseases like ulcerative or Crohn’s colitis.

IBS is a non-life threatening syndrome, a pattern of symptoms such as pain and bloating that tend to occur together. It is not a disease that can be caught or transmitted from person to person as a cold can nor can it be cured by an operation or medication.

What are the symptoms of IBS?
People with IBS may experience constipation, diarrhea, or a combination – constipation at some times and diarrhea at other times. In addition, IBS may produce cramps, urgency, or a gassy, bloated feeling in the abdomen. Mucus, sometimes seen in bowel movements, is also a symptom of IBS. Rectal bleeding is never caused by IBS, and any rectal bleeding must be properly and thoroughly evaluated.

What causes IBS?
The underlying cause of this disorder is an abnormality in the way the intestinal muscles contract. These muscles, which form the outer layer of the intestine, work automatically to move food products along the intestine to the rectum and out the anus. IBS is a disorder of the function of the intestinal muscles. Even when the muscles appear normal under a microscope, they may not function normally, contracting too forcefully or weakly, too slowly or rapidly, at certain times.

Although there is no physical obstruction, a patient may perceive cramps or functional blockage.

What role does stress play in IBS?
Emotional stress may contribute to IBS. The brain and the intestine are closely connected by nerve fibers that control the automatic functioning of the intestinal muscles, and many people may experience nausea or diarrhea when nervous or anxious. While we may not be able to control the effect stress has on our intestines, reducing the sources of stress in our lives – high pressure jobs, family tensions, etc. – may alleviate the symptoms of IBS.

How can I tell if the problem is IBS or something else?
A careful medical history and physical examination by a colon and rectal surgeon or other physician are essential to proper diagnosis. Tests performed to ensure that your symptoms are not caused by other problems may include a flexible sigmoidoscopic examination, colonoscopy, a hemmocult test to detect hidden blood in the stool, an x-ray examination of the lower intestines and psychological evaluation. These tests may rule out other diseases or conditions – cancer, diverticulitis, inflammation of the intestines or depression, for example.

How is IBS treated?
Simply understanding that IBS is not a serious or life-threatening condition may relieve anxiety and stress, which often contribute to the problem. Mental health counseling and stress reduction (relaxation training) can help relieve the symptoms of IBS in some individuals.

In others, increasing the amount of non-digestible, bulk-forming foods, or roughage, may be all that is needed to relieve symptoms. Adding roughage, such as psyllium seed, to your diet may eliminate or lessen the severity of cramps, result in softer stools that pass along the intestine more easily, and absorb excess water in the intestine to prevent diarrhea. When the major complaint is constipation, additional water should be provided in the diet along with bulk agents to soften the stool.

In some cases, dietary roughage alone may not provide adequate relief from cramping and bloating. Your physician may prescribe medications that act directly on the intestinal muscles to help the contractions return to normal. Some people obtain greater relief from one medication than another. Therefore, your physician may recommend changing medications to improve symptomatic relief.

Are there any foods to be avoided?
Sometimes, caffeine, milk products or alcohol can make symptoms of IBS worse. Your physician may recommend avoiding foods that contain significant amounts of caffeine – coffee, tea, chocolate and cola drinks, for example – and alcoholic beverages, including beer, wine and mixed drinks.

Your physician may also recommend that you avoid dairy products, such as cheese and milk, which may cause diarrhea in some people and constipation in others. Because dairy products are an important source of calcium and other nutrients that your body needs, be sure to get adequate nutrients in the foods that you substitute.

In addition, smokers should know that IBS symptoms may be aggravated by nicotine.

How long does the treatment take to relieve symptoms?
Relief of IBS Symptoms is often a slow process. It may take six months or more for definite improvement to be appreciated. Patience is extremely important in dealing with this problem.

The tendency for the intestine to respond to stress will always be present. With attention to proper diet, an increase in dietary roughage, and in some cases, use of appropriate medications, the symptoms of IBS can be greatly improved or eliminated. Mild symptoms may recur from time to time, but rarely will become more than a minor nuisance.

Can IBS lead to more serious problems?
IBS does not cause cancer, bleeding or inflammatory bowel diseases, such as ulcerative colitis. Over the long term, IBS can be associated with but does not cause diverticulosis. Treatment of IBS with bulk agents helps to prevent diverticulosis and other colon problems.

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