Fecal incontinence is a common, but rarely discussed problem that affects millions of people across the nation. Also called accidental bowel leakage, it involves a problem with bowel control that allows the involuntary passage of stool at times not of the patient’s choosing. Accidents can range from inadvertent passage of gas, to mild staining of the underclothing, to large accidents with complete loss of stool.


People with bowel control problems often suffer silently as they may be embarrassed or feel like they have an unusual problem. It is important to realize that this condition is very common among all age groups and genders, but severely under treated. Many patients will not even mention the problem to their doctors, assuming that there are no good treatment options available. Nothing could be further from the truth. Many people with FI can be effectively treated with medications and/or pelvic floor physical therapy. Until recently, patients who did not respond to the above measures had few options. Fortunately, we now have available sacral neuromodulation (Interstim), a minimally invasive treatment for fecal and urinary incontinence. A great majority of patients improve dramatically with this treatment, and up to 35% can gain complete control of their bowel function, allowing them to return to a happier, healthier lifestyle.



Many factors can lead to bowel control issues. They include:

 • Nerve or muscle damage sustained during childbirth – even many years ago

 • Gradual weakening of the sphincter or pelvic floor muscles

 • Chronic loose stools

 • IBS

 • Pelvic floor dysfunction or acquired anatomical abnormalities of the pelvic floor

 • Hemorrhoids

 • Bowel irregularity with wide swings in consistency of the stools



As there are multiple potential causes for FI, a few studies usually need to be performed to help clarify the situation and determine the treatment options available. These include:

 • An anorectal physical exam

 • Anal manometry – a simple office test that measures anal and rectal pressure and sensation

 • Defecography – an Xray test that visualizes the rectum and other pelvic structures which can identify various disorders of the pelvic floor

 • Office SNS test stimulation may be offered to determine whether or not you are a candidate for sacral neuromodulation



Treatment of FI depends on the main contributors to the problem. Options include:

 • Dietary modifications

 • Medications to help firm the stools

 • Pelvic floor physical therapy to help strengthen and train the pelvic and anal muscles

 • Treatment of anorectal disorders (such as hemorrhoids) that may contribute to leakage

 • In-office treatment with injectable bulking agents (Solesta) to treat mild leakage. This treatment is not generally effective for larger


 • Sacral neuromodulation



If dietary modifications, medications, and pelvic floor therapy don’t completely alleviate the problem, there is a newer, minimally invasive procedure that has been shown to be very effective for those with FI. This treatment has been safely and effectively used for 20 years in the treatment of both urinary and fecal incontinence in Europe, and since 1997 for urinary incontinence in the United States. A minor office test is performed first to determine who is an appropriate candidate for this treatment. In those who do qualify, up to 85% show significant improvement in their symptoms, and up to 35% will have virtually complete return of control.



Don’t let embarrassment or helplessness stand in the way of seeking care for this very treatable and often curable disorder. If you are troubled by FI, whether simply minor leakage or major accidents, and you’d like to get better, please call our main office number,

 (817) 410-7777, for an appointment. Our staff will schedule an initial consultation with Dr. Cox who will work with you to put you back in control.



"I had the Medtronic InterStim Implant for bowel control on 9/11/14.  I had suffered for 14 years with chronic diarrhea, having anywhere from 5 to 8 episodes per morning.  I had spent thousands and saw many, many gastroenterologist and holistic doctors and did acupuncture and colonics and whatever anyone else could think of to try. I did the trial InterStim and knew immediately that it was going to work for me.  I no longer have to wear Depends, and can plan my days with mornings away from the bathroom.  I wish I had found the COPE Center and Dr. Cox way sooner.  I have my life back.  I had no hesitation about having the surgery and the recovery time after the surgery was healed within a few days. I recommend this implant for anyone who is having bowel issues.

Don’t wait until you’re 69 – JUST DO IT!"


We are proud to be one of only a handful of clinics that offer a full range of surgical and non-surgical options to treat the entire spectrum of problems that can affect pelvic floor, colon, and rectum.


300 S. Nolen, Suite 100

Southlake, Texas 76092


Phone: 817.410.7777


Fax: 817.410.9906



Methodist Southlake


Grapevine Surgicare


Baylor Medical Center at Grapevine


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