TO YOUR HEALTH
Sacral Stimulation Restores Freedom to Those Living with Fecal Incontinence By Paul J. Watkins
Fecal incontinence, the accidental passing of bowel movements, is one of the most difficult-to-discuss health issues. People experiencing incontinence feel embarrassed, isolated, frustrated, and controlled by it. Often, they see no options but to wear adult diapers, withdraw from social activities, and avoid leaving their homes. “The most common cause of fecal incontinence for women in the U.S. is childbirth injury,” explains Mario Alcantara, MD, a board-certified general and colorectal surgeon at South Texas Colorectal Center in San Antonio. “This is followed by diabetes; increasing comorbidities, such as vascular disease; and dementia and other mental health issues. “When a patient complains of diarrhea or incontinence, the first thing we do, in addition to a complete workup, is rule out cancer. Next, we look at surgical history. Women who’ve had rectal cancer or cervical cancer and were treated with surgery and/or radiation are definitely at increased risk for fecal incontinence. “Treatment starts by dealing with the diarrhea. I’ll review any antidiarrheal medications the patient may be taking and put them on the proper ones. If there’s good improvement, we continue with the medication. If it fails, and other medications aren’t effective, we discuss the next step, which might be a sacral stimulator. Most patients who fail other treatments are candidates for it.” The device delivers miniscule electrical impulses to the nerves that regulate bowel movements, restoring the patient’s control. Use of the device for treating fecal incontinence received FDA approval in 2011. Dr. Alcantara and one of his practice partners were among the first in San Antonio to use it for that purpose.
Evaluating the stimulator’s effectiveness is simple, says Dr. Alcantara. “I put the patient under very mild anesthesia – sometimes in our office – and place a tiny needle, about the width of a human hair, into the foramen, which is a natural opening in the tailbone. A wire connects the needle to the stimulator, which is about the size of a thumbnail. I turn on the stimulator, bring the patient out of anesthesia, and the patient goes home, wearing the device on a belt.” After the needle has been in place for two or three days, the patient returns to the office for follow-up. Dr. Alcantara says the vast majority of his patients rave about the device’s benefits and ask to have it implanted. It’s placed under the skin of the upper buttock. “When the patient wakes up, the sacral stimulator is in place,” states the surgeon. Many physicians tell patients that fecal incontinence is just part of aging. Dr. Alcantara strongly disagrees, adding: “In my experience, it’s a result of disease, dysfunction, or a medication side effect. All of these can be addressed. “People suffering from fecal incontinence shouldn’t be ashamed,” he concludes. “Tell your doctor you have a problem. If the doctor says nothing can be done, find another doctor. There are options to treat this condition.”
Mario Alcantara, MD, FACS, FASCRS
For more information or to make an appointment, please visit www.SouthTexasColorectal.com. You can also call (210) 212-6202 for one of our six clinics in San Antonio and Schertz; and (830) 217-9794 for our New Braunfels clinic. 64
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