Faecal incontinence — difficulty controlling when you pass stool or wind — affects about 1 in 10 Australians. Because it feels embarrassing, many people suffer in silence for years before speaking to a doctor. But this is a medical condition, not a personal failing, and you shouldn't have to manage it alone. It can range from the occasional small leak to a more significant loss of control, and it can have a real impact on your confidence, social life, and emotional wellbeing. The important thing to know is that effective treatments exist for most people.
There are many possible causes, and often more than one is involved. The most common include weakness or damage to the muscles of the anal sphincter (the ring of muscle that controls the opening of your bowel) — which can happen after childbirth, previous anal surgery, or an injury. Nerve damage, a prolapsed rectum (where the rectum slips down through the anus), conditions like irritable bowel syndrome or inflammatory bowel disease, the effects of pelvic radiotherapy, and certain neurological conditions can all play a role too.
Coming to talk about this takes courage, and the assessment is conducted with complete sensitivity and respect for your privacy. Mr Nguyen will take a careful history to understand what you're experiencing, then perform a focused examination. Depending on what he finds, he may arrange some specific tests. Anorectal manometry measures the pressure and sensation in your anal canal and rectum — it's a gentle test done in a clinical setting. Endoanal ultrasound uses sound waves to look for any structural damage to the sphincter muscles. In some cases, additional imaging such as a defaecating proctogram or MRI may be used.
The good news is that many people see real improvement without any surgery at all. Simple measures — adjusting your diet, adding bulking agents to firm up the stool, anti-diarrhoeal medications, and working with a specialist pelvic floor physiotherapist — help a lot of patients. If these aren't enough, sacral neuromodulation (SNM) is a minimally invasive option with very good results. It works a bit like a pacemaker for your bowel: a small device is placed near the nerve roots at the base of your spine and delivers gentle, continuous electrical signals to help your bowel control improve. Response rates are around 70–80%. If tests show there is a structural tear in the sphincter muscle, a repair operation (sphincteroplasty) may be the better option.
Mr Nguyen understands how much courage it takes to seek help for this condition, and he approaches every consultation with care and discretion. His starting point is always the simplest, least invasive option — dietary changes, medication, and referral to a specialist pelvic floor physiotherapist. If those measures aren't giving you enough relief, sacral neuromodulation (SNM) is his preferred next step: it's minimally invasive, highly effective, and importantly, it's reversible — the device can be adjusted or removed if needed. For those with a clearly identified structural sphincter defect, sphincter repair (sphincteroplasty) is also available. The aim is always to find the most effective solution with the least intervention necessary.
If your symptoms are affecting your quality of life — even a little — please don't put off getting help. Faecal incontinence is not something you simply have to accept as an inevitable part of getting older, or as an unavoidable consequence of childbirth. You deserve to be assessed and treated. If you also notice rectal bleeding or a sudden significant change in your bowel habits, please seek review promptly.
Your GP will send a referral and most patients are seen within one to two weeks. The consultation is unhurried and private — Mr Nguyen will take a careful history, perform an examination, and discuss what is likely to be going on. Investigations such as anorectal manometry and endoanal ultrasound may be arranged to understand your sphincter function and anatomy clearly before any treatment plan is finalised.
Treatment is always stepwise and tailored to you. The first step is usually conservative — simple dietary changes, medication to firm the stool, and a course of biofeedback or pelvic floor physiotherapy. Many people improve substantially at this stage alone. If symptoms continue, sacral neuromodulation is the most common next step: a minimally invasive, reversible treatment with excellent results. For a clearly identified sphincter defect, sphincteroplasty may be considered. Follow-up is built into every stage so progress can be reviewed and the plan adjusted.
No — and this is really important to understand. It becomes more common with age, but it is not normal, and it's not something you should just put up with. With proper assessment, most people can be helped significantly.
Many people improve substantially with dietary changes, medication, and physiotherapy alone. If more is needed, sacral neuromodulation is a minimally invasive and reversible option — not open surgery. Formal sphincter repair is only considered when tests show a specific structural defect that's causing the problem.
Sacral neuromodulation involves implanting a small device near the nerves at the base of your spine. It delivers a very gentle, continuous electrical signal to help regulate bowel control. It's done in two stages: first a trial period to see if it helps you, then — if the trial is successful — a more permanent implant. It can be switched off, adjusted, or removed, so you're not committing to something irreversible.
Mr Ba Nguyen sees patients at his consulting rooms in Heidelberg. All consultations are conducted with complete discretion and respect. To book, you'll need a referral from your GP or another specialist.