Bladder, Bowels and the Brain

Doctors at Sanford Health recently put an implant into a patient to help her quality of life after she experienced side effects of fecal incontinence.

“To get outside of the house was a challenge,” Barbra Johnson, the woman who benefited from the implant, told the Forum. Johnson had to leave work early, rush to the bathroom during everyday things like running errands and sometimes had accidents.

In a study published in 2014, experts estimate that 8 to 10 percent of the adult population experience fecal incontinence with that number jumping to about 15 percent for adults over the age of 70.

Although Johnson is not the only one who lived with incontinence, she is in the minority in terms of seeking treatment. The same experts, surgical specialist M. Shane McNevin and general surgeons Michael Moore and Timothy Bax, predict that only 2 to 5 percent of these patients will “eventually seek treatment.”

“Symptoms of fecal incontinence are a common and under-reported source of social morbidity,” the experts wrote for the American Journal of Surgery. “Surgical intervention is typically reserved for those who fail medical therapy.”

The implant, which is called Insterstim and was surgically inserted, normalizes the neural connection between bladder, bowel and brain by stimulating nerves in the sacrum (the lowest part of the back).

After implantation, Johnson told the Forum that it started working immediately and she has total control once again.

Sacral nerve neuromodulation like this has been used to treat fecal incontinence since 1995, but has only been available in the US since 2011, according to surgeon Frederic J. Cole Jr.

Incontinence is a symptom and not a disease. Medical conditions that include incontinence as a symptom are urinary tract infection, neurological disorders — multiple sclerosis, Parkinson’s disease, stroke or brain tumor — an enlarged prostate, menopause, obstruction of the urinary tract of any time and constipation.

In Johnson’s case, muscle deterioration caused the incontinence.

Further causation of incontinence can range from consumption of diuretics in food, drink or medication and include alcohol, caffeine, chili peppers, large doses of vitamin C and heart or blood pressure medications, sedatives and muscle relaxants.

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