Diagnosis and Evaluation of Bowel Incontinence
Accurate diagnosis and evaluation of bowel incontinence involves a comprehensive approach to uncover the underlying cause. Many people feel embarrassed discussing it, but healthcare providers are trained to handle these conversations sensitively.
1. Medical history
- The doctor will ask about:
- Frequency and volume of leakage
- Stool consistency (diarrhoea or constipation)
- Dietary habits and medications
- Previous surgeries, childbirths, or medical conditions
- Ability to sense or delay bowel movements
2. Physical examination
- Includes inspection of the anal area and digital rectal examination to assess muscle tone and sensation.
- In women, a pelvic exam may be done to check for prolapse.
3. Tests and investigations
A. Anorectal manometry
- Measures strength and coordination of the rectal and anal muscles.
- Helps assess whether the sphincter is functioning properly.
B. Endoanal ultrasound
- A probe uses sound waves to create images of the sphincter muscles.
- Useful in identifying muscle tears or defects.
C. Defecography
- A special X-ray or MRI taken during defecation to observe the mechanics of the rectum and pelvic floor.
D. Colonoscopy or sigmoidoscopy
- Used to rule out tumours, inflammation, or structural causes such as strictures or cancer.
E. Stool tests
- Help identify infections or malabsorption conditions.
In South Africa:
- These diagnostic tools are more readily available in private facilities or academic hospitals.
- Public sector patients may face longer waiting periods or limited access to specialised testing.
Diagnosis and Evaluation of Bowel Incontinence
Despite these challenges, diagnosis is often possible based on history, exam findings, and simple in-clinic assessments — leading to practical, effective interventions.
👉 [Next: Treatment Options for Bowel Incontinence]
