The treatment of fecal incontinence entails;
1) Biofeedback; Pelvic floor exercises with biofeedback are beneficial when combined with the addition of dietary modifications. Biofeedback educates regarding pelvic floor coordination, recognition of sensory thresholds, and conditioning of the pelvic musculature, and it helps develop improved pelvic floor habits.
2) Dietary modification: a food diary may be useful to detect offensive items, such as citrus or spicy foods, caffeine, and alcohol, that may be associated with incontinence. Avoiding these may decrease the irritant load to the rectum.
3) Medications; The two most commonly used drugs are loperamide (Imodium) and diphenoxylate with atropine. Loperamide is currently the treatment of choice because it not only thickens the stool but also has been shown to increase anal sphincter tone and improve continence mechanisms. Since it is not working you may try diphenoxylate with atropine.
4) Sacral nerve stimulation.
Following investigations are needed for the identifying the cause, if this has been going on for more than 2-3 weeks;
1) Endoanal ultrasound,
4) Anorectal manometry
5) Anorectal electrophysiology testing.
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