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Fecal Incontinence

What is Fecal Incontinence?

Fecal incontinence, also known as bowel or anal incontinence, is the inability to control one’s own bowel movements. Fecal incontinence is a common but underreported condition.

Anal sphincters for control of Fecal Continence

The pelvic floor is a hammock of muscles which lies in the pelvis, supporting the internal organs, such as bowel, bladder and – in women – the uterus, to keep them in place. In the pelvic floor, there are a few muscles which are called Sphincters.

  • One differs between an internal and external sphincter which surround the anus.
  • These anal sphincter muscles naturally contract around the rectum and keep the fecal matter inside the body until one relaxes the sphincters while using the toilet.

Symptoms of Fecal Incontinence

Bowel incontinence can affect people in different ways, such as:

  • Sudden bowel movement which cannot be controlled
  • Soiling without realizing needing the toilet
  • Leakage of stool (e.g., while passing gas)
  • Daily or from time-to-time fecal incontinence episodes which are not due to diarrhea or another illness
  • Diminished Quality of Life (e.g., no socializing)

Treatment of Fecal Incontinence

Treatment can help to improve bowel incontinence and reduce the impact on daily life. Treatment for bowel incontinence includes conservative and surgical methods.

Conservative Treatment

  • Incontinence products: Such as pads for underwear or small plugs you place in your bottom
  • Changes to the diet: e.g. avoiding foods which cause diarrhea
  • Bowel retraining: Involves establishing the bowel into a regular routine
  • Biofeedback: Type of bowel training exercise which involves placing a small electric probe into the rectum
  • Tibial nerve stimulation: A small fine needle is inserted into the tibial nerve at the ankle which is connected to a stimulator device. The impulses travel along the nerve pathways and target the nerves responsible for bowel control)
  • Medicines to reduce constipation (e.g. laxatives) or diarrhea (e.g. loperamides)
  • Pelvic floor exercises: To strengthen the muscles used to control the bowels.

Available surgical treatment options are only considered when conservative methods have failed.

Surgical Treatment

  • Anterior sphincter Repair / Sphincteroplasty: An operation to repair damaged muscles in the anus
  • Sacral nerve stimulation: Placement of a small electronic device under the skin which helps the muscles and nerves in the anus to work better
  • Injectable bulking agents: Injection of a substance into the anal canal to bulk up the tissues and prevent leakage and improve control
  • Colostomy: Very occasionally and as a final treatment option. This is where the bowel is diverted through a hole made in the stomach = stoma, so the stool can be collected in a bag
  • Artificial anal sphincter: This involves the placement of an inflatable artificial sphincter around the anus. A pump – placed inside the body – is used to deflate the device, allowing fecal matter to pass through. The device then can be inflated / filled again, which closes the rectum.

Our product solution for Fecal Incontinence

Soft Anal Band

Soft Anal Band

Long-term implant to control sphincter function

Treatment of Fecal Incontinence in adults

What is the Soft Anal Band

The Soft Anal Band is a long-term subcutaneous implant to control the sphincter function for the treatment of fecal incontinence in adults.

  • The implant is based on a soft inflatable silicone band, which is placed around the anal sphincter and then closed to form a ring.
  • The anal band is placed around the non-functioning anal sphincter. By applying pressure from above skin level on activator/valve the anal band can be filled or emptied. This makes it possible to either open the ring (defecate) or close the ring (reduce fecal incontinence).
  • The system consists of the following components:
    • A soft, inflatable ring of silicone (Anal Band), which is implanted around the anal canal and can be adjusted in size.
    • A mechanism for closing the silicone ring – the activator.
    • A valve to open the band. The valve is typically implanted under the skin in the region of the pubic bone (front part of the pelvis), sternum (breast bone) or abdominal wall.
    • An access port, which is used to adjust the amount of liquid in the system and thereby the necessary pressure to close the sphincter.
  • Patients can activate the system manually and adapt the closure pressure individually.

What are the Benefits of the Soft Anal Band

  • Postoperative adjustment of the artificial anal sphincter is easy to accomplish.
  • Patients are able to activate the Soft Anal Band system independently without assistance by another person.
  • Soft Anal Band prevents episodes of incontinence without creating obstruction.
  • Soft Anal Band improves the patient´s Quality of Life (QoL).

[1] U. Baumgartner, “Der künstliche Sphinkter zur Therapie der Stuhlinkontinenz,” Zentralbl. Chir., vol. 137, no. 04, pp. 340–344, Aug. 2012, doi: 10.1055/s-0032-1315109.

[2] U. Baumgartner, “Technique of anal band implantation for fecal incontinence,” Coloproctology, no. 5, 2020, doi: 10.1007/s00053-020-00489-y.

[3] D. R. Chantoor et al., “THE ANAL BAND FOR SEVERE FAECAL INCONTINENCE: A MULTI-CENTRE EXPERIENCE,” Annu. Meet. Am., vol. 52, no. September, p. 152, 2009.

[4] M. Goos, U. Baumgartner, M. Löhnert, O. Thomusch, and G. Ruf, “Experience with a new prosthetic anal sphincter in three coloproctological centres,” BMC Surg., vol. 13, no. 1, p. 45, Dec. 2013, doi: 10.1186/1471-2482-13-45.

[5] D. Żelazny, M. Romaniszyn, and P. Wałęga, “Does Implantation of an Artificial Soft Anal Band Provide an Opportunity for Improvement of Biopsychosocial Function in Patients with Severe Fecal Incontinence?,” Surg. Res. Pract., vol. 2019, pp. 1–7, Oct. 2019, doi: 10.1155/2019/9843164.

[6] E. Asmaz and A. Cingi, “The effect of artificial anal band on quality of life of patients with fecal incontinence,” Ann. Med. Res., vol. 26, no. 0, p. 1, 2019, doi: 10.5455/annalsmedres.2019.05.234.

Soft Anal Band

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