YOUR BOWEL CONTROL
Bowel CONTROL SYMPTOMS
Millions of people are suffering in silence from bladder and bowel control issues1,2. Solutions exist.
Bowel control problems are treatable conditions and symptoms are manageable. Bowel incontinence is not a normal part of aging or an expected outcome after giving birth. It is a medical condition for which it is important to seek medical advice.
Bowel INCONTINENCE (BI)
Bowel control problems can be embarrassing and stop you from doing the things you want to do.
They can have a major negative impact on lifestyle as well as on both physical and psychological health leading to depression, loss of confidence, loss of self-esteem. You may have to cut back on your hobbies, stop working, feel trapped by a fear of leaking accidents, or feel the need to be close to a toilet at all times1,2.
WHAT IS Bowel INCONTINENCE?
Bowel incontinence prevents you from controlling your bowel movements.
You may experience unexpected leaks, or use the toilet very frequently.
Some people experience a combination of these symptoms.
WITH Bowel INCONTINENCE
- Have diarrhoea
- Feel the urgent need to go to the toilet and/or not reach the toilet on time
- Have constipation
- Stain or soil your underwear
YOU ARE NOT ALONE
Bowel incontinence is common and affects 4.8-6.7% of adults3.
You can suffer from both bladder and bowel problems.4
overactive bladder (OAB)
oab & bowel INCONTINENCE
QUALITY OF LIFE
Suffering from accidental bowel leakage can make everyday activities a challenge and socially very difficult7.
In a survey of 1096 women 45 years and above:
97% of patients expressed ‘bother’ about this condition.
A total of 39.2% of women with accidental bowel leakage were categorised as having severe impact on their quality of life.
29% of patients reported frequently feeling depressed. Almost one-third of women with accidental bowel leakage agreed that they felt they were fighting a losing battle.
FIND YOUR WAY TO REAL CONTROL
There are many ways to manage chronic fecal incontinence. Remember, if conservative treatments don’t deliver the results you need, you have more options.
“What is happening to me?”
Meet with a bowel incontinence specialist to see if you have chronic faecal incontinence.
“What should I try first?”
Relatively simple solutions can help some people, but may not work well for others.
- Dietary modification
- Physical therapy
- Bowel retraining (biofeedback)
“What if conservative treatments aren’t enough?”
Therapy that uses gentle nerve stimulation, which is thought to normalise bowel-brain communication to control the symptoms of chronic FI.
Medtronic Bowel Control Therapy delivered by the InterStim™ system
- Enable patients to experience relief during an evaluation
- 89% of people who tried this therapy experienced long-term success8*
Complications can occur with the evaluation, including movement of the wire, technical problems with the device, and some temporary pain. Your doctor or nurse will provide you with information regarding how to operate the test device and inform you of other precautions related to the evaluation and activity restrictions. Implanting an InterStim™ system has risks similar to any surgical procedure, including swelling, bruising, bleeding, and infection. Talk with your doctor about ways to minimise these risks.
*Success defined as greater than or equal to 50% reduction of episodes per week. This patient group had data at both baseline and the 5-year visit. Another analysis reported 69% of people achieved success with Medtronic Bowel Control Therapy.
For this patient group, missing data at 5 years because of a device-related reason was counted as failure; if it was missing for non-device-related reasons, the most recent data was carried forward.
This gel is injected as an implant into the anal canal to thicken the tissues and improve symptoms of chronic faecal incontinence.
- Does not address bowel-brain communication
- May cause unpleasant side effects
OTHER SURGICAL OPTIONS
Several other surgical options are available, all of which bring their own unique set of risks.
- Anal sphincter repair
- Artificial sphincter
- Antegrade colonic enema (ACE
WHAT IS SACRAL NEUROMODULATION?
Medtronic sacral neuromodulation with the InterStim™ system uses a small implanted medical device to send mild electrical pulses to nerves that control your bladder. It helps to restore normal nerve activity so that you can pass urine normally.10
HOW SACRAL NEUROMODULATION WORKS
Medtronic bowel control therapy works with the sacral nerves, located near the tailbone.
The sacral nerves control the bowel and muscles related to defecation function.
If the brain and sacral nerves are miscommunicating, the nerves can’t tell the bowel to function properly.
Sacral neuromodulation helps the brain and the nerves to communicate so the bowel and related muscles can function properly9.
It may help you resume normal activities and help you avoid frustrating or embarrassing experiences associated with bowel incontinence.
Sacral neuromodulation with InterStim™ system: an adjustable, reversible and lasting results therapy
01. Start with a test
With Medtronic bowel control therapy’s two-step process, you can test it out to see if it will work for you before making a long-term commitment. The testing period is called an “evaluation“. The evaluation is temporary and generally lasts around 1-2 weeks. It is used to measure the effectiveness of the InterStim™ therapy in your daily life.
- The test is started in a hospital setting and your consultant and/or nurse will tell you about the evaluation procedure. They will discuss the options for using either a temporary lead (a thin wire) or a long-term lead for the evaluation
- Before and during the evaluation, you’ll be asked to track your symptoms to help determine how well Medtronic bowel control therapy works for you
02. TOGETHER, DECIDE WHAT’S BEST FOR YOU
- If you experienced relief from your symptoms during the evaluation phase, you may be offered a permanent implant
- Together, you and your doctor will decide if the long-term therapy is the right choice. If it is, your evaluation device can be replaced with an implantable device called a neurostimulator
03. implant phase
If the evaluation phase was successful, your consultant may propose you the implant of an InterStim™ system. The InterStim™ system consists of:
- An implantable neurostimulator which is like a pacemaker implanted under the skin
- A lead which is a thin wire that carries mild electrical pulses to the nerves controlling the bladder
- A hand-held patient programmer that enables you to adjust the level of the stimulation and allows you to turn your neurostimulator on or off
04. life after therapy
Sacral neuromodulation therapy may allow you to resume many daily activities.
- Minimal follow up required - once per year recommended
- There is now recharge-free and rechargeable option available and your consultant will help you decide which option is best for you based on your needs
- InterStim™ SureScan™ and InterStim™ SureScan™ Micro™ are approved for MRI under specific conditions13**
CHOOSE A THERAPY WITH LONG-LASTING RESULTS
- Sacral neuromodulation is a well-established therapy
- 300,000 patients worldwide have received the InterStim™ system for bladder and bowel control
- The InterStim™ system has been available for over 25 years, treating on average 50 patients every day, for different indications worldwide†
†Medtronic data on file.
SACRAL NEUROMODULATION For BOWEL incontinence
patients satisfied with sacral neuromodulation10
success at 5 years11
See the device manual for detailed information regarding the instructions for use, implant procedure, indications, contraindications, warnings, precautions, and potential adverse events. See the MRI SureScan® technical manual before performing an MRI. For further information, contact your local Medtronic representative or consult the Medtronic website at www.medtronic.com.
Consult instructions for use at this website. Manuals can be viewed using a current version of any major Internet browser. For best results, use Adobe Acrobat Reader® with the browser.
* Battery longevity depends on therapy settings. Specific example was obtained in the treatment of fecal incontinence.
** Under certain conditions; see approved labeling for details.
1. Damon, H. et al. Prevalence of anal incontinence in adults and impact on quality-of-life. Gastroenterol. Clin. Biol. 30, 37–43 (2006)
2. Mundet, L., Ribas, Y., Arco, S. & Clavé, P. Quality of life differences in female and male patients with fecal incontinence. J. Neurogastroenterol. Motil. 22, 94–101 (2016)
3. Giebel et al. Prevalence of fecal incontinence: what can be expected? Int J Colorect Dis (1998) 13: 73–77
4. Soligo M, et al. Double Incontinence in Urogynecologic practice: A new insight; AM J Obstet Gynecol 189: 438 – 443 (2003).
5. Milsom, et al. “How widespread are the symptoms of an overactive bladder and how are they managed?“ A population-based prevalence study BJU Int. 2001 Jun; 87(9):760-6.
6. Markland AD et al. Associated factors and the impact of fecal incontinence in women with urge urinary incontinence: from the Urinary Incontinence Treatment Network’s Behavior Enhances Drug Reduction of Incontinence study. Am J Obstet Gynecol. 2009 Apr;200(4):424.e1-8. doi: 10.1016/j.ajog.2008.11.023. Epub 2009 Feb 6
7. Brown HW, Wexner SD, Segall MM, Brezoczky KL, Lukacz ES. Quality of life impact in women with accidental bowel leakage. Int J Clin Pract. 2012 Nov;66(11):1109-16
8. Hull T, Giese C, Wexner SD, et al. Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence. Dis Colon Rectum. 2013; 56(2):234-45.
9. Gourcerol G. et al. How sacral nerve stimulation works in patients with bowel incontinence. Colorectal Dis. 13(8):e203-11 (2011)
10. Widmann B et al. Success and Complication Rates After Sacral Neuromodulation for Fecal Incontinence and Constipation: A Single-center Follow-up Study. J Neurogastroenterol Motil. 2019 Jan 31;25(1):159-170.
11. Van Wunnik BP, Govaert B, Leong R, Nieman FH, Baeten CG. Patient experience and satisfaction with sacral neuromodulation: results of a single-center sample survey. Dis Colon Rectum. 2011 Jan;54(1):95-100.
12. Hull et al. Long-term Durability of Sacral Nerve Stimulation Therapy for Chronic Fecal Incontinence Dis Colon Rectum 2013; 56: 234–245 DOI: 10.1097/DCR.0b013e318276b24c.
13. Siegel, S., Noblett, K., Mangel J, et al. “ Five Year Follow-up Results of a Prospective, Multicenter Study in Overactive Bladder Subjects Treated with Sacral Neuromodulation.” J Urol.2018;199(1), 229 – 236.