Monroe Center woman helped by ‘life-changing’ fecal incontinence therapy

Sherrill Muller suffered with gastrointestinal (GI) issues for most of her adult life until a trip to Rockford Gastroenterology Associates (RGA) put her on the right path to diagnosis and treatment.

Muller’s issues with frequent diarrhea started more than 40 years ago. The 70-year-old Monroe Center resident was diagnosed early on with inflammation in her colon that was thought to be related to a form of colitis. Thankfully, the inflammation of her colon resolved, but she continued to have issues with fecal incontinence, causing frequent accidents.

For years, she managed her life around the symptoms – the attacks were immediate, without warning. She’d look for the closest bathrooms wherever she went and kept extra clothes and a bucket in the car in case she had an attack while traveling.

"I would be so careful about what I ate," Muller recalled. "If I knew I was dining out somewhere, I just wouldn’t eat.

"An attack would start out like a normal bowel movement, but it would last for hours. I was in the bathroom for hours until my whole system cleared out. Sometimes, I would be woken up in the middle of the night and I’d have accidents. That was really tough."

For decades, Muller used feminine pads to prevent embarrassing accidents. She struggled with being tired throughout the day because the attacks kept her up at night, and she was still working, raising two children with her husband and managing day-to-day life.

"Life doesn’t stop," she noted. "My boss at the time asked me what was wrong. It was such a delicate subject – I couldn’t confide in him. I was in banking, worked my way up to be a personal banker, and the problem is that even though you might have someone at your desk, you’d still have to excuse yourself to go to the bathroom. I did have a confidant who would take over for me, but you have no control. That’s where the frustration is, and people don’t understand that."

After many years of suffering, Sherrill reached out to RGA last year and met with Dr. Ilche Nonevski to discuss her symptoms and treatment options. She was diagnosed with fecal incontinence, which Dr. Nonevski reported affects almost 6 million Americans. "It’s more common in older adults and particularly women who describe tears, forceps deliveries or required episiotomy during childbirth. Problems with bowel and bladder control can show up many years later." Dr Nonevski added, "Patients will describe struggling with these symptoms for years but are often too embarrassed to discuss it, or feel like they have to just live with it. These symptoms take their lives hostage."

Sherrill felt a mix of frustration and relief knowing something that happened that long ago could have caused her issues, but, "I just wanted it fixed. I was to a point where I didn’t want to leave the house. I was retired, but I couldn’t go and do what I wanted."

Dr. Nonevski and his team at RGA performed a simple nerve test called InterStim™, which is an outpatient test that takes 15-20 minutes to perform and is meant to test the nerves that help control both our bowel movements and bladder emptying. "The nerve test involves inserting two very thin wires into the nerve canal at our tailbone which then deliver nerve impulses around the clock. Patients are able to control the amount of pulsation delivered to the area with a wireless remote control," Dr. Nonevski said. "Patients are asked to keep a detailed diary of symptoms before and for several days after the nerve test. If patients describe a greater than 50% improvement in symptoms, this tells us they would be good candidates for permanent implantation of a neuromodulator device." 

Soon after a successful test phase at RGA, Muller was referred to a board-certified Urogynecologist in Rockford who has partnered with RGA for the next phase of the InterStim™ trial. The permanent implantation consists of an outpatient procedure where new wires are placed more securely in the nerve canal and are connected to an implant that works like a pacemaker to deliver pulsation to the nerve and control symptoms.

The treatment was life-changing for Sherrill – it allowed her to travel on her first cruise to the Caribbean in early 2017 without worrying about attacks. "I’m not stuck in the bathroom all the time," she said. It’s been such a big relief to not have to worry about attacks and accidents all the time."

Since 2016, RGA physicians Dr. Nonevski and Dr. George Tannous have performed close to 40 trials that have led to excellent results for most patients after permanent placement.

Dr. Tannous, Director of the GI Motility program at RGA, noted that 82% of patients who underwent the trial InterStim™ through RGA achieved a greater than 50% improvement in fecal incontinence symptoms with the permanent implant. This is in line with data from clinical trials and other studies. Dr. Tannous went on to explain, "Of the patients that have followed up in our clinic so far, 92% report a significant improvement in their quality of life after therapy. Even more impressive is that nearly 3 out of 4 patients now describe their accidents as little to none."

Dr. Tannous added, "Another one of our patients would have up to 36 accidents per week. After completing treatment, she averaged only one."

Sacral neuromodulation with InterStim™ has been approved by the FDA for over 20 years for patients for patients with urinary bladder incontinence and since 2011 for fecal incontinence. RGA is one of only 50 GI groups in the nation invited to serve as a center for the InterStim™ trial phase.

"Since patients come to see us for a variety of GI symptoms, we have the opportunity to find out if they are also suffering from fecal incontinence," Dr. Nonevski said. "Giving these patients their lives back is one of the most meaningful services we can provide."

Muller no longer shies away from talking about her GI issues and hopes that sharing her decades-long struggle will help others. "God gave me extra time on this earth – I want to use it for the best things I can," she said. "If I can save somebody from all the pain and suffering I experienced, I’m all for it."

To learn more about fecal incontinence and other conditions we treat at RGA, visit https://www.rockfordgi.com/Coe.aspx

Please note that these experiences are specific to these particular patients. Not everyone who receives sacral neuromodulation should expect to achieve the same results as the patients in this story. Please refer to the Important Safety Information on the Medtronic site. Always discuss the potential risks and benefits of any therapy with your physician. This therapy is not appropriate for everyone and requires a prescription.