Fecal incontinence is the inability to control bowel movements, often leading to embarrassing and distressing situations. Dr. Albert Chung, a highly skilled and compassionate colorectal surgeon in Santa Margarita, CA, offers expert evaluation and customized treatments for fecal incontinence to help you regain confidence and control over your daily life. For compassionate, individualized care, call our colorectal clinic in Santa Ana at (714) 988-8690 to schedule your consultation.
Fecal incontinence affects approximately 18 million adults in the United States, with slightly higher prevalence in women. It occurs when there's a disruption in the normal bowel control mechanisms, causing involuntary leakage or complete loss of bowel control. Many patients suffer in silence for years because of embarrassment, not realizing how treatable the condition actually is. The impact on daily life is real, and proper diagnosis is the starting point for meaningful relief.
Fecal incontinence isn't a single condition. Understanding which type you have shapes treatment.
Patients experiencing fecal incontinence commonly report:
If any of these apply, an evaluation is worthwhile. Early treatment tends to work better than letting the condition settle in.
Several factors can contribute to fecal incontinence, often in combination. Identifying the underlying cause is essential for choosing the right treatment.
During your consultation, Dr. Chung will carefully discuss your symptoms, medical history, and lifestyle factors. A thorough physical examination follows, typically including a digital rectal exam to assess sphincter tone. Several diagnostic tests help pinpoint the underlying cause:
Treatment is highly individualized. Most patients improve with a combination of approaches, starting with conservative measures and escalating only if needed.
Recovery timelines and aftercare depend on the treatment approach. Dietary and pelvic floor interventions typically show results over weeks to months of consistent practice. Surgical and neuromodulation treatments have their own recovery timelines, with detailed postoperative guidance provided.
Ongoing follow-up helps fine-tune the treatment plan and maintain progress. Most patients experience meaningful improvement and regain confidence in daily activities.
This page is about fecal incontinence, the loss of control over stool or gas. Urinary and stress incontinence involve the bladder and are treated by urologists and urogynecologists. The two often occur together, especially after childbirth, because the same pelvic floor muscles and nerves support both. If you have both, Dr. Chung treats the bowel side and can coordinate with a pelvic floor specialist for the rest. Pelvic floor physical therapy frequently helps both at once.
Vaginal delivery is the most common cause of fecal incontinence in women, and the damage often does not show up until years or decades later. A third- or fourth-degree tear, forceps delivery, or a large baby can injure the anal sphincter muscle or stretch the pudendal nerve. The sphincter compensates for a while; then aging, menopause, or a bout of diarrhea tips the balance and symptoms appear. Many women assume this is a normal part of aging and never mention it. It is not, and it is treatable. An endoanal ultrasound shows whether the sphincter is torn, and that single finding determines whether the best treatment is muscle strengthening, nerve stimulation, or repair.
Sacral nerve stimulation is the most significant advance in fecal incontinence treatment in a generation, and it has largely replaced sphincter repair for patients whose problem is not a simple, recent muscle tear. A thin lead is placed next to the sacral nerve that controls the rectum and sphincter, and a small stimulator, similar to a pacemaker, delivers a gentle current that improves the coordination of the muscles and the sensation of the rectum. The treatment happens in two steps: a test phase of one to two weeks with a temporary external stimulator, during which you keep a bowel diary, and then, if accidents have fallen by at least half (which is the case for most patients), permanent implantation of the device under the skin of the upper buttock. Both steps are short outpatient procedures. Published series report that around three quarters of patients maintain a major improvement at five years, and the device can be turned off or removed at any time.
| Underlying cause | First-line treatment | If that is not enough |
|---|---|---|
| Loose stool overwhelming a normal sphincter | Fiber, diet changes, loperamide, treating the cause of diarrhea | Bile acid binders; evaluation for IBD or other causes |
| Weak but intact sphincter | Pelvic floor physical therapy with biofeedback | Sacral neuromodulation |
| Torn sphincter from childbirth or injury | Pelvic floor therapy; sphincteroplasty for recent, well-defined tears | Sacral neuromodulation, which works even with a defect |
| Nerve damage (diabetes, spinal injury, pudendal neuropathy) | Bowel routine, stool consistency management | Sacral neuromodulation |
| Overflow from constipation | Bowel regimen to clear and prevent impaction | Evaluation for pelvic floor dyssynergia |
| Rectal prolapse or large hemorrhoids | Repair of the prolapse or hemorrhoids | Reassess continence after repair |
Fecal incontinence is under-treated in Orange County for the same reason it is everywhere: patients do not bring it up, and many physicians do not ask. Dr. Chung offers the full evaluation, including anorectal manometry and endoanal ultrasound, and every current treatment from pelvic floor therapy to sacral neuromodulation and sphincter repair, in a setting built to make the conversation easy.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
Often, or at least improved to the point where it no longer affects daily life. Dietary and medication changes help most patients with loose-stool incontinence. Pelvic floor therapy and sacral neuromodulation produce major improvement in the majority of patients with muscle weakness or nerve problems, and sphincter repair can restore control after a discrete tear.
No. Testing (manometry and ultrasound) involves a small probe and is uncomfortable at most. Pelvic floor therapy and biofeedback are painless. Sacral neuromodulation involves two short outpatient procedures with local anesthesia and sedation, and most patients describe the stimulation as a mild tingling or nothing at all.
As soon as it is happening regularly enough to change how you live: avoiding outings, wearing pads, or planning your day around bathrooms. Earlier treatment works better, and the evaluation is simpler than most patients expect.
Fecal incontinence is loss of control over stool or gas and is treated by a colorectal surgeon. Urinary incontinence is loss of bladder control and is treated by a urologist or urogynecologist. They share causes, particularly childbirth injury and pelvic floor weakness, and often improve together with pelvic floor therapy.
A small implanted device, similar to a pacemaker, that stimulates the sacral nerve controlling the rectum and anal sphincter. It is tested first with a temporary lead for one to two weeks, and implanted permanently only if it works. It is the most effective treatment for fecal incontinence that has not responded to conservative care.
Evaluation, pelvic floor physical therapy, sacral neuromodulation, and sphincter repair are generally covered as medically necessary treatments, subject to your plan's deductible and any prior authorization requirements. The office verifies coverage before any procedure is scheduled.
Fecal incontinence is a medical condition, not something to be embarrassed about. Dr. Chung treats this condition with the matter-of-factness it deserves. A consultation is confidential, straightforward, and often the beginning of real improvement.
Book a consultation Call (714) 988-8690Many patients achieve significant improvement or full resolution with appropriate treatments tailored to their specific condition.
Most treatments for fecal incontinence, including surgical options, involve minimal discomfort. Dr. Chung prioritizes patient comfort and utilizes techniques designed to reduce pain and accelerate recovery.
Seek medical evaluation as soon as symptoms disrupt your daily life or cause emotional distress, as early intervention provides the best outcomes.
Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
