Bowel leakage and accidental bowel leakage in Lawrenceville, Braselton and Oakwood

What does bowel leakage feel like?

Accidental bowel leakage is the everyday name patients use for fecal incontinence or bowel incontinence: stool escapes, from a smear on underwear to a full accident, without you choosing that moment. For some people it is a small smear of leaking stool when they pass gas. For others it is a sudden urge and a complete loss of bowel control, sometimes described as "I can't control my bowels." Many people start planning errands around bathrooms, or they wear a pad, and they put off talking about it.

The pattern matters at the visit: how often it happens, whether there is warning, whether diarrhea or constipation came first, and whether bladder leakage is happening at the same time. Women and men from Lawrenceville, Dacula, Braselton, Hoschton, Jefferson, Buford, Oakwood, Gainesville and Flowery Branch are seen for this at our three offices.

What causes accidental bowel leakage?

Several problems can weaken the muscles or the nerves that keep stool in. Muscle injury around the anus can follow a vaginal delivery. Nerve injury can follow aging, diabetes, a stroke or surgery in the pelvic area. Loose stools give the rectum less time to hold on, and chronic constipation can stretch the rectum and lead to overflow leakage. Often more than one of these is in play, which is why the first visit is about finding the contributors rather than guessing.

Our urologists follow the evaluation described on the fecal incontinence page on advancedurology.com. This page cannot diagnose the cause for you; that is what the visit is for.

When should you go to the emergency room for bowel leakage?

Go to an emergency room, or call 911, if bowel leakage is new and comes with numbness in the groin or legs, rectal bleeding, black stool, a fever, or a sudden change in bowel habits. Those signs can point to a nerve, bowel or infectious problem that should not wait for a scheduled visit.

Leakage that has been going on for weeks or months, without those warning signs, is still worth a visit with our urologists, but it can be booked as a regular appointment rather than an emergency-room trip.

What happens at a bowel leakage visit?

The visit starts with a private conversation about the leakage, your diet, medicines, pregnancies, surgeries and any bladder symptoms. An exam of the abdomen and the pelvic floor usually follows. A stool diary, a few days of notes on meals, trips and accidents, is one of the most useful things you can bring. Depending on what we find, the next steps may include a stool test, imaging, or a closer look at how the rectum and the nerves around it are working.

You can have that first visit at our Lawrenceville Clinic & Surgery Center on Crown Pointe Way, our Braselton Clinic on Old Winder Hwy, or our Oakwood Clinic on Mundy Mill Road. All three offices evaluate and treat fecal incontinence. If an InterStim test or implant is the right next step, that procedure is done at the Lawrenceville surgery center.

How is fecal incontinence treated?

Care starts with conservative steps, then moves on if those are not enough, as outlined on the Advanced Urology fecal incontinence page.

• Diet and fiber. Adjusting fiber and spotting foods or drinks that loosen or firm the stool can cut down on accidents.
• Bowel retraining. Scheduled bathroom times and, when it fits, biofeedback to improve sensation, coordination and muscle strength.
• Pelvic floor work. Guided exercises to strengthen the muscles that help hold stool.
• Medication. When habits are not enough, medicines may be used to firm loose stool or to help a sluggish bowel move more regularly.
• InterStim for bowel control. If leakage or urgency continues after those steps, sacral nerve stimulation with the InterStim system may be an option. Our InterStim for bowel control page explains the test phase and the implant, and the neuromodulation therapy page on advancedurology.com has the practice-wide overview.

Can bladder and bowel leakage happen together?

Yes. The same sacral nerves help control the bladder and the bowel, so urge leaks, frequent urination or overactive bladder can show up alongside accidental bowel leakage. Our urologists can evaluate both at the same visit. InterStim is used for certain bladder conditions as well as for chronic fecal incontinence, which is one reason a combined workup is useful. Urine leakage and urgency on their own are covered on our leaking or urgency page and our overactive bladder treatment page.

What do patients ask?

What is the difference between bowel leakage and fecal incontinence?

They describe the same problem: stool leaking when you did not intend it, from a small smear to a complete loss of bowel control. Patients more often search for bowel leakage or accidental bowel leakage, and clinicians often write fecal incontinence or bowel incontinence on the chart.

Can I get fecal incontinence treatment in Lawrenceville, Braselton or Oakwood?

Yes. All three of our offices evaluate and treat bowel leakage for patients across Gwinnett, Hall, Barrow and nearby Jackson-area towns. The InterStim test and the permanent implant, when they are recommended, are performed at our Lawrenceville Clinic & Surgery Center on Crown Pointe Way, and follow-up can return to the office you already use.

I can't control my bowels after childbirth. Should I still come in?

Yes. Muscle or nerve injury around the anus after a vaginal delivery is a common reason women develop accidental bowel leakage, and it is treatable. The visit reviews the delivery history, checks the pelvic floor and usually starts with diet, bowel retraining and pelvic floor work before any procedure is discussed.

When should leaking stool send me to the emergency room?

New leakage with numbness in the groin or legs, rectal bleeding, black stool, a fever, or a sudden change in bowel habits needs an emergency room, or 911 if you cannot get there. Leakage that has been present for a while, without those signs, can be booked as a regular visit.

Do you treat bowel incontinence and bladder leakage together?

Yes. Tell us about both, because the workup can cover them in one plan. InterStim is an option for some people with chronic fecal incontinence and for some bladder conditions, so a combined evaluation can keep those choices in view.

What should I bring to a bowel leakage appointment?

Bring a list of medicines, a short history of pregnancies or pelvic surgery, and a few days of notes on meals, bathroom trips and accidents if you can. Wear something you can change out of easily for the exam, and write down the questions you most want answered.

Which video can help?

Who sees patients for bowel leakage at our offices?

These are the urologists and physician assistants who see patients at our Lawrenceville, Braselton and Oakwood offices. Physician assistants see patients for evaluation and follow-up; InterStim testing and implants are performed by our urologists.

• Dr. Hemant Chaparala, Urologist: sees patients at Lawrenceville, Braselton and Oakwood
• Dr. Vik Sabarwal, Urologist: sees patients at Lawrenceville and Braselton
• Dr. Michael F. Nordsiek, Urologist: sees patients at Lawrenceville
• Dr. Nicholas Farber, Urologist: sees patients at Braselton
• Dr. Mukesh Patel, Urologist: sees patients at Lawrenceville
• Ian Thomas, PA-C, Physician Assistant: sees patients at Lawrenceville and Oakwood
• Jordon Blackmon, PA-C, Physician Assistant: sees patients at Lawrenceville
• Lucy Choi, PA-C, Physician Assistant: sees patients at Lawrenceville and Braselton
• Sarah Nayebosadri, PA-C, Physician Assistant: sees patients at Braselton
• Lauren Goring, PA-C, Physician Assistant: sees patients at Braselton and Oakwood

Where can you be seen for this?

Our Lawrenceville Clinic & Surgery Center on Crown Pointe Way has exam rooms, imaging and an outpatient surgery center under one roof. Our Braselton Clinic on Old Winder Hwy cares for Braselton, Hoschton, Jefferson and Buford families. Gainesville, Flowery Branch and other Hall County patients are seen at our Oakwood Clinic on Mundy Mill Road. Any procedure from the Braselton or Oakwood offices is done at the Lawrenceville surgery center.