Breakthrough Therapy for Fecal Incontinence Treatment

InterStim (Sacral Nerve Stimulation)and Solesta Injection Therapy

Most people feel more than a bit uneasy when they consider talking to their friends, family, and doctor about bowel incontinence. If you suffer from the inability to control your bowel movements, you are not alone. This condition affects millions of people. According to the National Institute of Health, more than 18 million Americans suffer from fecal incontinence.15% of women over age 50 experience FI. Men are affected but less often than women.

The surgeons, nurses, nurse practitioners and physician assistants at RCRS take a special interest in fecal incontinence and offer minimally invasive techniques(like InterStim Therapy) and office based injection therapy (like Solesta) to help you finding relief from the loss of bowel control.

Definition of FI:

Bowel incontinence, also known as fecal incontinence (FI), prevents you from controlling your bowel movements. You may experience unexpected leaks, or use the bathroom very frequently. Some people experience a combination of these symptoms.

Causes:

Bowel incontinence is usually an acquired disorder. It may be caused by:

  • Obstetrical injury from pregnancy or childbirth
  • Stroke or advanced age
  • Nerve or muscular damage caused by surgery or injury
  • Conditions that affect the nerves, such as diabetes, Parkinson’s disease, and multiple sclerosis
  • Inflammatory bowel disease and irritable bowel syndrome
  • Congenital disorders

Some people may suffer from bowel incontinence due to not being able to sense a bowel movement, while others are able to sense a bowel movement but can’t hold it until they get to a bathroom.

Conservative Therapy:

Behavioral Techniques

Some people can reduce their bowel control symptoms with lifestyle changes, diet modification, bowel retraining, Kegel exercises, or other kinds of physical therapy.

Medications

Your doctor may prescribe medications to help control the symptoms of bowel incontinence. Medications used for bowel control problems offer a possible solution and may include anti-diarrheal medicines.

Outcomes with conservative management are often poor and FI often persists. Sphincter muscle surgery has been used with limited success. A colostomy (?stool bag?) is common. It works well. Understandably we all prefer to avoid ?a bag?.

New options to treat FI if conservative therapy has not been successful:

1. Solesta Injection Therapy

Solesta is composed of naturally made materials called dextranomer and sodium hyaluronate. The gel is similar to the natural starches, sugars, and tissue in your body. Solesta is an option after conservative methods have failed, but before you consider undergoing surgery.

Improvements with Solesta:

Solesta can reduce fecal incontinence accidents (or loss of bowel control) and provide long-lasting results. Solesta can also improve quality of life. What?s more, Solesta is proven safe. In clinical studies, patients kept track of their accidents and leaks in personal diaries after their treatment with Solesta. Most patients noticed a reduction in accidents (of up to 60%) and other changes that helped improve their lifestyle.

Here?s how it works:

solesta

Solesta is a gel that is given through 4 injections into the wall of the anal canal. It helps give you more control by bulking up the tissue in the anal canal. Since the injections are well tolerated by most patients, anesthesia is not necessary. Solesta is injected during an office visit.

  • The Solesta treatment procedure is done in your doctor?s office and takes about 10 minutes
  • No anesthesia is required
  • You may resume limited physical activity immediately after the procedure
  • You can resume a normal lifestyle and all physical activities after 1 week
  • Solesta may begin working soon after the procedure, with optimal results at 3 months for many patients
  • The effectiveness of Solesta continues over time. Solesta was shown to be effective in patients for 2 years, and patients’ results are still being followed for a 3-year period.

To learn more about Solesta visit: http://www.solestainfo.com/patients/how_solesta_can_help.aspx

2. InterStim Therapy

The surgeons at RCRS offer neuromodulation to selected patients who have not had success with, or are not a candidate for, more conservative treatments (see above).

InterStim Therapy (SNS) is an FDA-approved neurostimulation therapy that targets the communication problem between the brain and the nerves that control bowel function. If those nerves are not communicating correctly, the bowel muscles may not function properly and may cause bowel control problems.

Neurostimulation can eliminate or reduce your symptoms to a tolerable level and allow you to resume your daily activities and “get your life back”.

Is InterStim Therapy (SNS) Right for You?

InterStim Therapy is designed to minimize the symptoms of bowel incontinence, including the leakage of liquid or solid stools.Prior to undergoing a permanent implantation of the neurostimulation device patients undergo a trial assessment. This lets you try neurostimulation to see if it is right for you without making a long-term commitment. The trial assessment may take a few to several days to complete.

Here?s how it works:

InterStim picture

  • InterStim Therapy is an outpatient procedure that is performed in the operating room
  • Your doctor will implant a thin, flexible wire (also known as a “lead,” and pronounced “leed”) near your tailbone. The wire is taped to your skin and connected to a small external device which you?ll wear on your waistband
  • The external device sends mild electrical pulses through the wire to nerves near your tailbone. The stimulation may get your bowel working the way it is supposed to. During the trial assessment, you’ll wear an external neurostimulator on your waistband for several days. You can continue many of your low- to moderate-level daily activities with caution. You can usually continue to work throughout your trial assessment if your job doesn?t require strenuous movement
  • You?ll be asked to document your symptoms. The trial assessment will help your doctor determine the next course of treatment for your bowel control problems. Your doctor or nurse will give you information about operating the test stimulator. He or she will also tell you about any precautions or activity restrictions related to the trial assessment
  • If neurostimulation has worked for you in the trial period, a flexible wire (also known as a ?lead? and pronounced ?leed?) and a neurostimulator are implanted under the skin permanently. This is done during a minimally invasive outpatient procedure.

Living with InterStim Therapy

InterStim Therapy may help you avoid frustrating experiences associated with bowel incontinence.You may be able to do things you were not able to do before receiving InterStim Therapy ? take long walks through the park, see movies at the theater, or travel. While it may take a while to adjust to the therapy, you should feel comfortable participating in the daily activities of living.

Remember:Even after you?ve made a full recovery from surgery and resumed your normal routine, it?s important to stay in touch with your doctor about any questions or concerns you have.

To learn more about InterStim Therapy and/ orSolesta Injection Therapy and to find out if you are a candidate, please call any of our offices or schedule an appointment.

Please note: In order to become a candidate for InterStim orSolesta therapy, insurance approval is required prior to implantation of the Interstim device/ injection of Solesta. Rest assured – Rochester Colon and Rectal Surgeons will not only help you determine if InterStim or SolestaTherapy is right for you. We will also work with you and assist you in obtaining coverage from your insurance provider.