From Mayo Clinic's Discovery's Edge magazine
Imagine the distress of waiting in a stalled checkout line, the bathrooms located at the back of the store, when your bowels begin to rumble and you have the uncontrollable urge to go. For those with fecal incontinence, panic ensues with the very thought of being caught unprepared at moments like these.
Mayo Clinic gastroenterologist Dr. Adil Bharucha has heard too many stories from his patients, mainly women over 40, about the panic created by the inability to control bowel movements, causing stool to leak unexpectedly from the rectum. In the worst cases, fecal incontinence can lead to a complete loss of bowel control.
Since one in 10 women experiences this embarrassing condition and since the prevalence increases with age, fecal incontinence was once thought to be the results of trauma during childbirth. Dr. Bharucha discovered, however, that rectal urgency and diarrhea, rather than obstetric trauma, are the main risk factors for fecal incontinence among women
He also knew he needed better diagnostic tools to identify and assess anorectal function if he hoped to help women suffering from fecal incontinence. With that goal, he set about building an extensive network of collaborators both within Mayo Clinic and externally to develop new diagnostic tests and devices. This work has led him to collaborating widely across the institution to improve care for the patient.
The work of Dr. Bharucha and his research colleagues has earned international acclaim for Mayo Clinic's gastrointestinal motility clinic, the first center nationwide to introduce high resolution anorectal manometry into clinical practice; and to develop normal values and a system with which to classify patients with defecatory disorders, including fecal incontinence. It now offers a panel of tests to assess rectal stiffness, sphincter strength and urgency. This comprehensive approach provides an array of sophisticated diagnostic tools to help researchers zero in on the cause for fecal incontinence in each patient.
"Most of my collaborators had never considered working in my field," Dr. Bharucha says. "I am very grateful for their enthusiasm and expertise once they understood how common and distressing these disorders are. People say that the beauty of collaborating is that you work with smarter people. In my case, it's really true."
And, as a result, many women are also grateful to Dr. Bharucha for seeking new answers and new tests with his colleagues for this all too common and embarrassing condition.