Fecal incontinence is an inability to control bowel movements, resulting in involuntary soiling. It is also called bowel incontinence. There may be excessive wind or staining of underwear. In some cases, individuals may lose only a small amount of liquid waste. In other instances, the solid bowel movement cannot be controlled. Poor bowel control can be caused or made worse by a number of things including certain health conditions or medicines taken for other problems. Incontinence is a sign that something is wrong – some part of the bowel control system is not working as it should.
Incontinence can affect people of any age, although it's more common in elderly people. It's also more common in women than men. It's important to remember that fecal incontinence isn't something to be ashamed of, neither is it a normal part of ageing. It won't usually go away on its own – most people need treatment for the condition.
Causes Of Fecal Incontinence
Normal control of bowel movements depends on a number of factors that include the amount and consistency of stools, as well as proper functioning of the colon, rectum, muscles surrounding the anus (anal sphincter muscles), and nervous system (brain and spinal cord). Any condition that interferes with these complex mechanisms may result in incontinence.
Factors that can lead to loss of bowel control include:
- Muscle damage to the anal sphincter muscles
- Reduced muscle tone due to normal aging
- Nerve damage or injuries to the pelvic floor resulting from vaginal delivery or any surgery in the region
- Neurological disorders such as stroke or diabetes
- Conditions that affect the nerves, including spinal cord injury
- Conditions associated with chronic constipation or diarrhea
- Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disease (IBD)
- Certain medications
- Radiation treatment for certain cancers
- Improper diet
Symptoms Of Fecal Incontinence
- Stool leaks out when passing gas
- Stool leaks out due to physical activity/daily life exertions
- A person may "feel like he/she has to go" and not be able to make it to the bathroom in time
- Stool is seen in the underwear after a normal bowel movement
- There is complete loss of bowel control
Diagnosis Of Fecal Incontinence
Visit your doctor if you have concerns about bowel control. Remember, incontinence can be prevented, treated, better managed or cured. You shouldn't be embarrassed to discuss your bowel problems as many other people experience similar problems too.
Fecal incontinence can cause embarrassment, low self esteem, and loneliness. Taking steps to cope with it is important. There are a lot of treatment options that ensure a better quality of life if not complete cure, and can mean the difference between social isolation and a productive life.Treatment for bowel incontinence depends on underlying cause and the pattern of your symptoms. Trying the less invasive treatments first, such as dietary changes and exercise programs, is often recommended.
LEARN MORE ABOUT YOUR TREATMENT
The various treatment options for fecal incontinence include:
- Dietary changes
- Bowel training
I. DIETARY CHANGES
The influence of diet on incontinence is unique to each individual and there is no generalized dietary advice that will work for everyone. We offer a customized diet plan after taking a detailed history of your disease and symptoms. Based on that, we recommend a list of foods that are advisable and those that are not. For example, certain foods are known to stimulate bowel movement, and in those with bowel incontinence, eating too much of these might provoke unwanted reactions. Some foods are gas producing (e.g., beans, cabbage, legumes, cauliflower, broccoli, lentils, raisins, onions) and eating too much may cause increased gaseousness. Other foods can be odor forming with gas. These foods may include alcohol, asparagus, beans, cabbage, chicken, coffee, cucumbers, dairy products, eggs, fish, garlic, nuts, onions, radishes, and highly seasoned foods.
Bowel incontinence associated with diarrhoea or constipation can often be controlled by making changes to your diet.
Medications can help improve diarrhea and constipation or assist in the development of a more predictable bowel pattern. Examples include antidiarrheal medications, laxatives, fiber supplements, and stool softeners.
III. BOWEL TRAINING
Bowel training involves developing a regular bowel movement pattern. For example, trying to have bowel movements at specific times of the day, such as after every meal. This is best suited for people with reduced sensation in their rectum as a result of nerve damage, or for those who have recurring episodes of constipation. Establishing a regular time to empty your bowels means finding the most convenient time when you can go to the toilet without having to rush. Persistence is key to successful bowel training. Achieving a regular bowel control pattern can take weeks to months.
IV. PELVIC FLOOR EXERCISES
The pelvic floor muscles are layers of muscle in the pelvis that support the anal opening. If they are weakened or not in good condition they cannot support the opening effectively. When a muscle is not exercised it will weaken through lack of use and the pelvic floor muscles are no exception. Exercises that strengthen the pelvic floor muscles may improve bowel control. Pelvic floor exercises involve squeezing and relaxing pelvic floor muscles 50 to 100 times a day. At Healing Hands Clinic, a pelvic floor physiotherapist will guide you regarding the correct technique and schedule for performing these exercises.
Biofeedback is a type of bowel retraining exercise that involves placing a small electric probe into your bottom. It is a painless process that uses a computer and a video monitor to display bodily functions. The sensor relays detailed information about the movement and pressure of the muscles in your rectum to an attached computer. You're then asked to perform a series of exercises designed to improve your bowel function. The sensor checks that you are performing the exercises in the right way.
Surgery is not the answer for all patients with incontinence but for appropriately selected patients it can restore their continence. It may be an option for fecal incontinence that fails to improve with other treatments or for fecal incontinence caused by pelvic floor or anal sphincter muscle injuries. The kind of surgery you need depends on the underlying cause and will be best explained by your proctologist.