Weakened rectal muscles can cause fecal incontinence, defined as the inability to control bowel movements. Although it can be embarrassing and unpleasant, fecal incontinence is far from uncommon; the American College of Gastroenterologists reports that 5.5 million Americans have the condition at any given time. Exercises to strengthen the rectal muscles are an important part of treatment for fecal incontinence. If you have symptoms of weakened rectal muscles or incontinence, consult your doctor first to rule out dangerous diagnoses.
Fecal incontinence--also called bowel incontinence and anal incontinence--is more common with older adults and occurs when the anal sphincter muscles fail to function properly. Symptoms of fecal incontinence can range in severity from leakage of a small amount of stool when passing gas to a total loss of bowel control. Fecal incontinence is diagnosed with anal monometry, which measures pressure in the anus, as well as ultrasound, MRIs, EMGs and barium studies. A proctosigmoidoscopy--an examination of the rectum and sigmoid colon with the aid of a tiny video camera--may also be performed.
Changes in bowel habits, such as diarrhea, can cause fecal incontinence; persistent constipation can also cause incontinence by stretching and weakening muscles in the rectum and anus that are responsible for holding stool. Other causes of incontinence include damage to the sphincter muscles, often resulting from childbirth, inflammation, scar tissue, or tumors, and damage to the rectal nerves from excessive straining, diabetes, multiple sclerosis or a stroke. Finally, Crohn's disease can cause stiffness in the rectal wall, making it difficult for the tissues to stretch; as a result, stool may leak out unexpectedly.
Fecal incontinence is often treated with dietary changes. Your doctor may advise you to avoid foods with laxative effects if you have diarrhea, or to eat more fiber if you have constipation. To help strengthen weakened anal sphincter muscles, your doctor may recommend bowel retraining, in which you try to eliminate on a schedule, or biofeedback. In severe cases, surgery may be required.
Kegel exercises, also called pelvic floor exercises, can help reduce fecal incontinence by strengthening rectal muscles. To perform them, tighten the muscles of the anus, buttocks and pelvis as if you were trying to prevent the escape of stool or gas. Hold the muscles as tightly as you can for at least five seconds, then relax. Do 30 of these at a time, three times daily, for a total of 90 Kegels a day. This regimen may cause improvement in fecal incontinence within a matter of weeks.