Fecal Incontinence Treatment in Mumbai– Dr. Husain Gheewala

About Dr. Husain Gheewala

Fecal incontinence — the inability to control bowel movements — is a deeply distressing condition that affects more people than most realize. If you are struggling with accidental bowel leakage, you are not alone, and effective treatment is available. Dr. Husain Gheewala is a specialist colorectal surgeon in Mumbai with dedicated expertise in diagnosing and treating fecal incontinence using a comprehensive range of conservative, interventional, and surgical approaches.

With a 2-year fellowship in colorectal surgery from York NHS Hospital (UK) — where pelvic floor and incontinence management is a core component of training — and robotic surgery certification from Seoul, Dr. Gheewala offers the full spectrum of treatment options from biofeedback therapy to advanced sphincter repair and sacral nerve stimulation.

What Is Fecal Incontinence?

Fecal incontinence (also called bowel incontinence or anal incontinence) is the involuntary loss of stool or gas from the rectum. It ranges from occasional minor leakage to complete loss of bowel control. The condition can occur in several forms:

• Urge incontinence — sudden, intense need to have a bowel movement with inability to reach the toilet in time
• Passive incontinence — stool or mucus leaks without any sensation or awareness
• Flatal incontinence — inability to control the passage of gas
• Soiling — minor staining of undergarments between bowel movements

Fecal incontinence is far more common than most people believe. Studies estimate that 7-15% of adults experience some degree of bowel incontinence, though most never seek help due to embarrassment. It is not a normal part of ageing, and in the majority of cases, it can be significantly improved or cured with appropriate treatment.

Causes of Fecal Incontinence

• Obstetric (Childbirth) Injury: The most common cause in women. Vaginal delivery — especially forceps delivery, prolonged labour, or large babies — can tear the anal sphincter muscles. The injury may not be recognized at the time and symptoms may appear years or decades later.
• Sphincter Damage from Surgery: Previous anorectal surgery (fistula surgery, hemorrhoidectomy, lateral sphincterotomy) can damage the sphincter muscles if not performed carefully by a specialist.
• Rectal Prolapse: When the rectum protrudes through the anus, it stretches and weakens the sphincter muscles, leading to progressive incontinence.
• Nerve Damage: Diabetes, spinal cord injuries, stroke, and neurological conditions can damage the nerves controlling the sphincter and pelvic floor muscles.
• Ageing & Pelvic Floor Weakness: Natural weakening of pelvic floor muscles and reduced sphincter tone with age, especially in women after menopause.
• Inflammatory Bowel Disease: Crohn’s disease and ulcerative colitis can cause urgency, frequent stools, and incontinence, particularly during disease flares.
• Radiation Therapy: Pelvic radiation for cervical, prostate, or rectal cancer can damage the rectum and sphincter, causing incontinence.

Diagnosis: How We Assess Incontinence

Dr. Gheewala follows a systematic, evidence-based approach to diagnosing the cause and severity of fecal incontinence:

• Detailed History & Severity Assessment: A confidential discussion of symptoms, bowel habits, obstetric history, previous surgeries, and impact on quality of life. Validated scoring systems (Wexner/Cleveland Clinic score) are used to objectively assess severity.
• Physical Examination: Gentle digital rectal examination to assess sphincter tone, squeeze pressure, and detect any structural abnormalities.
• Endoanal Ultrasound: An ultrasound probe is used to visualize the anal sphincter muscles and identify any tears, defects, or thinning — crucial for planning surgical repair.
• Anorectal Manometry: Measures the pressures generated by the anal sphincter at rest and during squeeze, providing objective data about sphincter function.
• MRI Pelvis: For complex cases, MRI provides detailed images of the pelvic floor muscles, sphincter anatomy, and any associated conditions.
• Colonoscopy / Flexible Sigmoidoscopy: May be recommended to rule out inflammatory bowel disease, rectal pathology, or other causes of altered bowel function.