Use of sacral nerve stimulation for the treatment of overlapping constipation and fecal incontinence

Gouri Sreepati, Toyia James-Stevenson

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective: Rare co-existance of disease or pathology Background: Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. Case Report: A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction. Pelvic floor testing showed poor ability to squeeze the anal sphincter, which indicated sphincter weakness as a major contributor to her fecal incontinence symptoms. Additionally, on defecography she was unable to widen her posterior anorectal angle or relax the anal sphincter during defecation consistent with dyssynergic defecation. A sacral nerve stimula-tor was placed for management of her fecal incontinence. Interestingly, her constipation also dramatically improved with sacral neuromodulation. Conclusions: This unique case highlights the emerging role of sacral nerve stimulation in the treatment of complex pelvic floor dysfunction with improvement in symptoms beyond fecal incontinence in a patient with dyssynergic-type constipation.

Original languageEnglish (US)
Article number901821
Pages (from-to)230-233
Number of pages4
JournalAmerican Journal of Case Reports
Volume18
DOIs
StatePublished - Mar 7 2017

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Keywords

  • Constipation
  • Fecal incontinence
  • Spina bifida occulta

ASJC Scopus subject areas

  • Medicine(all)

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