In 2007 the National Institutes of Health released a statement on Fecal and Urinary Incontinence. Retrospectively, it’s important to look at any gains made in condition awareness, as well as treatment options.
In 2007 there were no available treatment options to help patients who did not respond to conservative therapy and did not want to have surgery. Since 2007 there have been several products introduced to market.
– Secca Therapy, a radiofrequency treatment of the muscle of the internal anal sphincter that improves bowel control.
– Solesta, an injectable bulking agent.
– Sacral Nerve Stimulation, an implanted device that stimulates the nerves that control the muscles of the anus.
Pelvic Floor Centers have opened all over the world to specifically address the problems encountered by women that cause Urinary or Bowel Incontinence. These centers pull together specialties like Gynecology, Colorectal and Urogynecology to offer an array of testing and treatment options.
Social media has taken the conversation to a new level, and previously underserved patients now have a platform to anonymously discuss their quality of life and treatment issues. This has also allowed foundations to communicate better with the patients they are trying to reach.
A recognition that Fecal Incontinence is an orphan illness has been evidenced by the word “Incontinence” being used when referring to Urinary Incontinence only, even in medical journals. This is currently being addressed by a noticeable shift in consumer terminology to “Bowel Control” problems, or “Bowel Control Disorder (BCD)”. In June of 2011 the NIH launched a website entitled “Let’s Talk About Bowel Control,” a campaign specifically designed to increase awareness of this orphan illness. Additionally several device manufacturers and physicians have been using these terms with the goal of softening the patient conversation, and providing an identity to the incontinence stepchild that nobody likes to talk about.
While awareness has improved, there is much more to be done. None of these new and promising therapies are widely covered by insurance companies or medicare, making the patient’s situation more difficult by delaying or denying payment for these new, yet proven therapies. It is illogical and immoral that these patients are abandoned by health insurance while yearly costs for Fecal Incontinence have been estimated at over $4,000 per person. Patients and their providers need to contact their insurance company or congressman to pressure them to cover their chosen treatment option for Fecal Incontinence.
Five years after the NIH released their important statement on Fecal and Urinary Incontinence, there is progress and reason for hope. Unfortunately until payors recognize the debilitating nature of these illnesses and the actual long-term cost savings involved in providing treatment options, patient suffering and isolation will continue.