Bowel incontinence – Illnesses & conditions

Treatment for bowel incontinence depends on underlying cause and the pattern of your symptoms.

Trying the least intrusive treatments first, such as dietary changes and exercise programmes, is often recommended.

Medication and surgery are usually only considered if other treatments haven’t worked.

The various treatments for bowel incontinence are outlined below. 

Continence products

You may find it helpful to use continence products until your bowel incontinence is better controlled. Most continence products are available for free on the NHS.

Anal plugs are one way to prevent involuntary soiling. An anal plug is made of foam and designed to be inserted into your bottom. However, they can be uncomfortable and they’re not really a long term solution.

If the plug comes into contact with moisture from the bowel, it expands and prevents leakage or soiling. Anal plugs can be worn for up to 12 hours, after which time they are removed using an attached string.

Disposable body pads are contoured pads that soak up liquid stools and protect your skin. They can be used in cases of mild bowel incontinence.

Single-use silicone inserts, which form a seal around the rectum until your next bowel movement, are also being investigated as a treatment option for moderate to severe bowel incontinence.

Your local NHS continence service can offer help and advice about continence products, and you don’t usually need a referral from your GP to make an appointment. These clinics are staffed by nurses who specialise in continence treatment.

When you’re out

• Wear trousers or skirts that are easy to undo and have elasticated waistbands rather than buttons.
• Disability Rights UK offers access to 9,000 disabled toilets around the UK with a Radar NKS key. The key costs £4.50 and is only sold to people who require use of toilet facilities due to a disability or health condition.

Dietary changes

Bowel incontinence associated with diarrhoea or constipation can often be controlled by making changes to your diet.

It may be beneficial to keep a food diary to record the effect of your diet on your symptoms.

Diarrhoea

The National Institute for Health and Care Excellence (NICE) has published dietary advice for managing diarrhoea in cases of irritable bowel syndrome. These guidelines can also be applied to people with diarrhoea associated with bowel incontinence.

The advice from NICE includes the following:

• limit fibre intake from wholegrain breads, bran, cereals, nuts and seeds (except golden linseeds)
• avoid skin, pips and pith from fruit and vegetables
• limit fresh and dried fruit to 3 portions a day and fruit juice to 1 small glass a day (make up the recommended ‘5 a day’ with vegetables)
• limit how often you have fizzy drinks and drinks containing caffeine
• avoid foods high in fat, such as chips, fast foods and burgers

Constipation

A high-fibre diet is usually recommended for most people with constipation-associated bowel incontinence. Your GP can tell you if a high-fibre diet is suitable for you.

Fibre can soften stools, making them easier to pass. Foods that are high in fibre include:

• fruit and vegetables
• beans
• wholegrain rice
• wholewheat pasta
• wholemeal bread
• seeds, nuts and oats

Drink plenty of fluids because this can help to soften your stools and make them easier to pass.

Pelvic floor muscle training

Pelvic floor muscle training is a type of exercise programme used to treat cases of bowel incontinence caused by weakness in the pelvic floor muscles.

A therapist, usually a physiotherapist or specialist nurse, will teach you a range of exercises. The goal of pelvic floor muscle training is to strengthen any muscles that may have been stretched and weakened.

You’ll probably be required to carry out the exercises 3 times a day, for 6 to 8 weeks. After this time, you should notice an improvement in your symptoms.

Exercises to try

Check with your health professional before trying these at home.

First, pretend you’re trying to hold in a bowel movement. You should feel the muscles around your anus tighten.

Next, sit, stand, or lie in a comfortable position with your legs slightly apart.

• Squeeze your pelvic floor muscles for as long as you can, then relax. Repeat 5 times.
• Squeeze the muscles as hard as you can, then relax. Repeat 5 times.
• Squeeze the muscles quickly, then relax. Repeat 5 times.

If you find these exercises too difficult, try fewer repetitions at first and build them up. If they get too easy, try doing more repetitions. You can do the exercises without anyone knowing about them, so they should be easy to fit into your daily routine.

Bowel retraining

Bowel retraining is a type of treatment for people with reduced sensation in their rectum as a result of nerve damage, or for those who have recurring episodes of constipation.

There are 3 goals in bowel retraining:

• to improve the consistency of your stools
• to establish a regular time for you to empty your bowels
• to find ways of stimulating your bowels to empty themselves

Changes to your diet usually improve stool consistency (see above).

Establishing a regular time to empty your bowels means finding the most convenient time when you can go to the toilet without being rushed.

Ways to stimulate bowel movements can differ from person to person. Some people find a hot drink and meal can help. Others may need to stimulate their anus using their finger.

Biofeedback

Biofeedback is a type of bowel retraining exercise that involves placing a small electric probe into your bottom.

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.

Medication

Medication can be used to help treat soft or loose stools or constipation associated with bowel incontinence.

Loperamide is a medicine widely used to treat diarrhoea. It works by slowing down the movement of stools through the digestive system, allowing more water to be absorbed from the stools. Loperamide can be prescribed in low doses to be taken regularly over a long period of time.

Laxatives are used to treat constipation. They’re a type of medicine that helps you to pass stools. Bulk-forming laxatives are usually recommended. These help your stools to retain fluid. This means they’re less likely to dry out, which can lead to faecal impaction.

Enemas or rectal irrigation

Rectal irrigation or enemas are used when bowel incontinence is caused by faecal impaction and other treatments have failed to remove the impacted stool from the rectum.

These procedures involve a small tube that is placed into your anus. A special solution is then used to wash out your rectum.

Surgery

Surgery is usually only recommended after all other treatment options have been tried.

The main surgical treatments used on the NHS are sphincteroplasty and sacral nerve stimulation. Other treatments – such as tibial nerve stimulation, endoscopic heat therapy and artificial sphincter surgery – can also be used, but their availability on the NHS is limited.

An operation called a colostomy is more widely available on the NHS, but it’s only used if other treatments are unsuccessful.

These treatments are outlined in more detail below.

Sphincteroplasty

A sphincteroplasty is an operation to repair damaged sphincter muscles. The surgeon removes some of the muscle tissue and the muscle edges are overlapped and sewn back together. This provides extra support to the muscles, which makes them stronger.

Sacral nerve stimulation

Sacral nerve stimulation is a treatment used for people with weakened sphincter muscles.

Electrodes are inserted under the skin in the lower back and connected to a pulse generator. The generator releases pulses of electricity that stimulate the sacral nerves, which causes the sphincter and pelvic floor muscles to work more effectively.

At first, the pulse generator is located outside your body. If the treatment is effective, the pulse generator will be implanted deep under the skin in your back.

The most commonly reported complications of the procedure are infection at the site of surgery and technical problems with the pulse generator, which require additional surgery to correct.

See the NICE guidelines on Sacral nerve stimulation for faecal incontinence.

Tibial nerve stimulation

Tibial nerve stimulation is a fairly new treatment for bowel incontinence.

A fine needle is inserted into the tibial nerve just above the ankle and an electrode is placed on the foot. A mild electric current is passed through the needle to stimulate the tibial nerve. It’s not known exactly how this treatment works, but it’s thought to work in a similar way to sacral nerve stimulation.

NICE concludes that the procedure appears to be safe, although there are still uncertainties about how well it works.

See the NICE guidelines on Treating faecal incontinence by stimulating the tibial nerve.

Injectable bulking agents

Bulking agents, such as collagen or silicone, can be injected into the muscles of the sphincter and rectum to strengthen them.

The use of bulking agents in this way is a fairly new technique, so there’s little information about their long-term effectiveness and safety.

You should discuss the possible advantages and disadvantages of this type of treatment in full with your treatment team before deciding whether to proceed.

See the NICE guidelines on Treating faecal incontinence with injectable bulking agents.

Endoscopic heat therapy

Endoscopic radiofrequency (heat) therapy is a fairly new treatment for bowel incontinence.

Heat energy is applied to the sphincter muscles through a thin probe, to encourage scarring of the tissue. This helps tighten the muscles and helps to control bowel movements.

The National Institute for Health and Care Excellence (NICE) recently produced guidelines on this procedure. NICE concluded that the procedure appears to be safe, although there are still uncertainties about how well it works.

As well as the uncertainties surrounding this procedure, it is also expensive. Therefore, it is usually only used on the NHS during clinical trials.

See the NICE guidelines on Treating faecal incontinence using endoscopic radiofrequency therapy.

Artificial sphincter

An artificial sphincter may be implanted if you have bowel incontinence caused by a problem with your sphincter muscles.

This operation involves placing a circular cuff under the skin around the anus. The cuff is filled with fluid and sits tightly around the anus, keeping it closed.

A tube is placed under the skin from the cuff to a control pump. In men, the pump is placed near the testicles, in women it’s placed near the vagina. A special balloon is placed into the tummy, and this is connected to the control pump by tubing that runs under the skin.

The pump is activated by pressing a button located under the skin. This drains the fluid from the cuff into the balloon, so your anus opens and you can pass stools. When you are finished, the fluid slowly refills the cuff and the anus closes.

The use of an artificial sphincter is a relatively new procedure, so there isn’t much good-quality information about its long-term effectiveness and safety.

Possible problems include infection, injury during surgery and the cuff becoming dislodged. In some cases, further surgery is required to correct problems.

See the NICE guidelines on Treating faecal incontinence with an artificial sphincter inserted through a cut in the abdomen.

Colostomy

A colostomy is usually only recommended if other surgical treatments are unsuccessful.

A colostomy is a surgical procedure in which your colon (lower bowel) is cut and brought through the wall of your stomach to create an artificial opening. Your stools can then be collected in a bag, known as a colostomy bag, which is attached to the opening.

Fecal Incontinence in Women: Q&A with an Expert

Like the kids’ book says, everyone poops. And at some point, some of us feel like we’re going to poop in our pants. It might be during the onset of a stomach bug, the weeks you spend recovering from childbirth or when that laxative kicks in while you’re out shopping.

Fecal incontinence is not something anyone wants to talk about, but it’s extremely common, affecting up to one in four women at some point in their lives. Many women who experience occasional or chronic stool leakage may feel embarrassed about it, but they should know that treatment can help.

Grace Chen, M.D., a urogynecologist at the Johns Hopkins Women’s Center for Pelvic Health and Reconstructive Surgery, talks about the causes and treatments of fecal incontinence.

What is fecal incontinence?

Fecal incontinence means your body can’t control its own bowel movements, resulting in leakage of stool. Here’s how that happens: Muscles in your gastrointestinal tract move the contents of your gut (food you’ve eaten that’s being digested) through your body. Once all of the nutrients are absorbed, what’s left is stool, which sits in the colon until you have a bowel movement.

Your anal sphincter is a muscle that holds the anus closed so stool doesn’t leak out until you’re ready to go. When the sphincter doesn’t do its job — or if your stool is too loose or even too hard — leakage can happen.

Fecal incontinence can occur once in a while or it may happen all the time. Symptoms include:

• Inability to resist the urge to defecate
• Not getting to the toilet fast enough
• Being unaware of the need to go

What causes fecal incontinence?

Age is the biggest risk factor for fecal incontinence; it’s a condition that primarily affects older women. But it can also occur in younger women. Other risk factors and causes of fecal incontinence include:

• Constipation: “When you’re constipated, you can have liquid stool around impacted feces in your colon,” says Chen. “Hard stool makes it difficult for one of the anal sphincters to contract, allowing liquid material to seep through.”
• Diarrhea: Loose stool is harder to control, and even the rare bout of diarrhea can cause leakage.
• Childbirth: “Research shows if you have a vaginal delivery, particularly an assisted delivery, you may be at more risk for developing fecal incontinence,” says Chen. Assisted delivery techniques include forceps, vacuum or episiotomy, where the doctor makes a cut in the tissue between the vagina and anus for easier delivery.
• Nerve or muscle damage: Any damage to the nerves that signals the need for a bowel movement or the muscles that control bowel movements can cause fecal incontinence. Causes of nerve damage include surgery, childbirth, spinal cord injury or other chronic health conditions, such as diabetes and multiple sclerosis.
• Rectal conditions: Rectal scarring from surgery or radiation therapy can keep the rectum from stretching. This can allow stool to leak out. Rectal prolapse, where the rectum slips into the anus, can also cause fecal incontinence.
• Bowel problems: Any condition that causes diarrhea raises your risk of fecal incontinence. These conditions may include Crohn’s disease, ulcerative colitis and irritable bowel syndrome.
• Mobility problems: Leakage is more likely to happen to people who have trouble getting to the bathroom fast enough. This can be due to physical disability or age-related mobility problems. Inactivity can also cause constipation that contributes to fecal incontinence.

What are treatments for fecal incontinence?

Because of the wide variety of causes, treating fecal incontinence might involve seeing multiple medical professionals. But the good news is that it isn’t just something you have to live with, and you’ll have many experts in your corner. “You should try to get your bowel symptoms managed as best as possible,” says Chen. “Gynecologists, gastroenterologists, physical therapists and colorectal surgeons all work together to treat fecal incontinence.”

Your medical team will focus on approaches such as:

• Improving stool quality: Regulating your stool consistency can reduce the likelihood of leakage. Medicine can help control chronic diarrhea or constipation, while fiber supplements can help increase the bulk of your stool.
• Physical therapy: Research shows physical therapy can help control fecal incontinence, such as in cases with nerve damage from childbirth.
• Medical devices: Nerve stimulation devices appear to work as well as surgery to improve muscle control in the anus. Other devices to improve bowel control include a vaginal insert designed to prevent stool from leaking out of the anus.
• Surgery: If you have a condition such as rectal prolapse, surgery may be able to help.

So when should you get treatment for fecal incontinence? Chen says women should see a doctor when fecal incontinence bothers them, even if it only happens once in a while.

“If fecal incontinence is lowering your quality of life or causing other problems, such as skin irritation, you may want to see a doctor,” says Chen. If you’re nervous about what the doctor might recommend, Chen says the important thing to know is that talking to a doctor doesn’t mean committing to treatment. “The more informed you are, the more empowered you’ll be to make an educated decision,” she says.

Disturbed stool in a child, causes and treatment of stool in children

Disturbed stool in a child

In childhood, stool disorder is the most common reason for visiting a doctor. In children, disorders of the gastrointestinal tract may manifest as diarrhea, constipation, or fatty stools.

In childhood, stool disorder is the most common reason for visiting a doctor. In children, disorders of the gastrointestinal tract may manifest as diarrhea, constipation, or fatty stools.

Parents need to remember that a violation of the stool in a child can signal serious illnesses, which means that it is necessary to immediately contact a gastroenterologist who will identify the causes of the disorder and prescribe adequate treatment.

Types and causes of stool disorders in children

Diarrhea

Most often, diarrhea in children occurs against the background of intestinal infections. An increase in the incidence is observed in the summer period. In young patients, diarrhea may be accompanied by nausea, vomiting, and fever. In the event of an acute attack of diarrhea, the child should be taken to the doctor immediately. It is important to contact the nearest medical center for medical care for children.

Such a center is the Baby Plus children’s medical center, which is located in the village of VNIISSOK (Odintsovo district, residential complex “Gusarskaya ballad”). Since it is very important to see a doctor in the first hours of a child’s illness, especially when the body temperature rises, residents of Odintsovo can call a doctor at home for a timely examination of the baby.

Constipation

Many parents do not pay due attention to constipation in young children. Indeed, with constipation, dehydration of the body is not observed, there is no loss of useful trace elements and vitamins, as with diarrhea. However, constipation, especially frequent, may indicate many diseases of the gastrointestinal tract.

In order that later these diseases do not bring irreparable harm to the health of the baby, parents need to show the baby to a specialist. The gastroenterologist will quickly determine the causes of the disease and prescribe the appropriate treatment, which is most often limited to a special diet and the introduction of certain foods into the child’s diet. Medications may also be prescribed.

Fat stool

Fatty stools can occur with both diarrhea and constipation in a child. If your baby has feces that are poorly washed off the walls of the potty or toilet, and also leaves greasy stains that do not wash off on diapers or panties, you should urgently seek advice from a pediatric gastroenterologist. The doctor, first of all, must exclude a violation of the digestion of fats contained in food, and determine the cause of this disease.

For this, the child is prescribed an examination, which is most often carried out in a hospital. Based on the results of the examination, the doctor prescribes adequate treatment, which includes a certain diet and medication.

Specialists of the Baby Plus Medical Center strongly recommend contacting qualified doctors in case of any stool disorder in children. This is due to the fact that the child’s body cannot fight many disorders on its own, and uncontrolled self-medication can aggravate the situation, and in this case, treatment can be delayed for a long time. Remember that a child’s stool is an indicator of his health.

Date posted: 12/13/2018 5:05:15 PM

Uncontrolled stool (asked by Anonymous) in 2357181 topic

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04.08.2010 22:40

Who came across, tell me, my grandmother is 85 years old, she poops for the last 3 days but does not understand what is happening, what is it connected with? (poops quite often)

Anonymous

04. 08.2010 22:59

“but does not understand that this is happening” – what do you mean, does not understand because of what? or pants?

Nadusha I C.B.

08/05/2010 12:15

does not understand what pooping or pissing, those at that moment do not go to the toilet but poop in their sleep, on a chair, etc.

Anonymous

05.08.2010 12:34

if this was not the case before, then most likely because of the heat the cerebral circulation was disturbed. It would be nice to have a grandmother under condo, pierce cerebrolysin intramuscularly 5 ml 1 time per day = 10 injections, drink picamilon 1t 3 times a day = 30 days, noopept 1t 3 times a day = 30 days, encephalobol 1t 3 times per day = 30 days. Better yet, show a good neurologist and gerontologist

Nadusha I C.B.

08/05/2010 13:49

Yes, it is with this diagnosis that we are lying, how to stop the process of clogging or until the symptoms pass, nothing will help?

Anonymous

08/05/2010 14:21

I wrote to you about medicines. And now what do they give her?

Nadusha I C.B.

05.08.2010 15:33

Excuse me, are you a doctor? How can you recommend drugs online, and even with a dosage! Mayhem!

Anonymous

08/05/2010 15:42

nope. That’s horror!

Nadusha I C.B.

08/05/2010 18:12

Fool. Sorry. There are no other words…

Anonymous

08/05/2010 19:51

I will not forgive. You can not find words – be silent.

Nadusha I C.B.

08/06/2010 04:24

When I see such brainless behavior, I am unable to remain silent. Do you have a prescription for such cases?

Anonymous

08/06/2010 19:26

You said above, “there are no words. ” What appeared? The author is a sane person, he has a doctor with whom she consults. It’s just that all human doctors can forget, not remember, think what is dear to the patient. I ate a dog on violations of cerebral circulation. Have you seen here that I advised someone else in such detail? No. The author’s situation is terrible, but I can help – why not…

Nadusha I C.B.

05.08.2010 15:26

detrolex, mexidol, vazobral, cordiamine, because the pressure is low, crap very often – eats very little

Anonymous

08/05/2010 15:41

normal. I would also inject Cerebrolysin

Nadusha I C.B.

08/05/2010 16:12

Those after these drugs should pass, but will it continue to crap?

Anonymous

08/05/2010 16:22

Well, medicine is not an exact science. .. You are doing what you have to. My grandmother at one time came to her senses completely. Is she at the b-tse or at home?

Nadusha I C.B.

08/05/2010 16:28

At home, who needs them in the b-tse, I’m already taking the 6th injection, at the beginning there was an insight and improvement, I began to walk and even speak intelligible sentences, and for the last three days I’ve been shitting a lot and often, I think mozht fixing something to give, or will not help? :(( At home, a small child, constantly have to wash her in the bathroom, well, you know…

Anonymous

08/05/2010 16:39

talk to your doctor about Cerebrolysin. I really sympathize – I myself, unfortunately, have been in this situation more than once. Pamers, wet wipes, disposable diapers.

Nadusha I C.B.

08/05/2010 16:42

Yes, buy adult diapers, you certainly shouldn’t feel sorry for the money for this – such a salvation if it happened that an elderly person began to walk under himself! No stench, no smeared linen . .. This is me, of course, the author, and not you Nadya!

Anonymous

08/05/2010 16:55

There are diapers, but this is not salvation. Wash the ass anyway, especially the grandmother walking.

Anonymous

05.08.2010 16:56

Did you feel better after Cerobrolysin?

Anonymous

08/05/2010 17:18

definitely.

Nadusha I C.B.

08/05/2010 17:47

just talked to the doctor, says cerebrorelisin is hard for her with such vessels, says actovegin to inject more

Anonymous

08/05/2010 19:49

Actovegin is a good thing. Pts. good injections of Cerepro (or Gliatilin), but I don’t know at what stage they are prescribed. And in tablets. Expensive only. And you need to drink / inject for a long time. Up to 6 months About the vessels, I don’t know, the doctor, of course, knows better than me from here. I’m not a doctor, it’s just that around me there is a violation of the brain.

Nadusha I C.B.

08/05/2010 20:38

and I thought you were a doctor telling the author in such detail

IRRik V.I.P.

08/06/2010 00:51

why detralex?

Anonymous

06.08.2010 01:07

legs swollen

Anonymous

08/06/2010 02:13

Detralex is an angioprotector, but it does not relieve swelling. In addition, it does not have the best effect on the stomach.

Seklet Lemerich C.B.

08/06/2010 14:24

What is an angioprotector?

Anonymous

06. 08.2010 02:17

Cerepro is an interesting drug, but again, the doctor must decide. The good old piracetam (nootropil) can still be remembered, but it is advisable to drip it.

Seklet Lemerich C.B.

08/06/2010 22:15

Mucus with blood appeared in the stool, what is it connected with, poop once.

Author

07.08.2010 22:16

see a doctor already!

Anonymous

08.08.2010 13:33

went to the doctor, I want some opinions and experiences of other people

Anonymous

07.08.2010 22:37

this is another problem… Is it possible to call a doctor until Monday? Grandma didn’t get better with her head?

Nadusha I C. B.

08/08/2010 13:34

Better. Now this is another thing, although it happened only once

Anonymous

08/08/2010 16:29

Thank God!!! What did the doctor say about blood in the stool?

Nadusha I C.B.

08/08/2010 16:33

He said to call a therapist, the neurologist did not say anything specific

Anonymous

08.08.2010 17:08

was the blood scarlet or dark?

Nadusha I C.B.

08.08.2010 19:36

some dark clots

Anonymous

08/08/2010 20:11

call the therapist tomorrow.

Nadusha I C. B.

08.08.2010 20:58

I already decided so, but I don’t have the strength, small children at home, constant crap, washing, stink … this is horror, they won’t put them in the hospital – they are not needed there, and the nurse is also not a panacea – the stench of the exact same thing and wash and poop in the apartment … I am in despair, and the local therapists are not helpers.

Anonymous

08/08/2010 21:16

I’m very sorry! My mother-in-law after a stroke spent three months only lying down. But somehow there was no particular stench – diapers, wet wipes, airing … She had a stroke 21 Jan. happened, and we managed to drag her to the bath for the first time (she weighs 95 kg) in early April … Maybe you shouldn’t drag her to the bath every time? A nurse, if it is possible for money, makes life easier, because even if there is a smell, then you can only deal with children. If you get your head right, it will become much easier. There are paid clinics and nursing departments, but be patient, suddenly the grandmother’s head will fall into place – then the crap will stop. Really good establishments are very expensive, but anyhow, where would be a pity for a loved one. At my late grandmother’s at 93 years one to one like yours was, she came to her senses, then she lived in her mind for another six months. Maybe this is our punishment, or a test of our love and strength. Hold on! I understand that with two kids it is difficult. I have younger students, but it was still hard. If you need to talk – write in a personal – we’ll call you. I raised my grandmother, I raise my mother-in-law for the second time after strokes, my mother has vascular dementia – there are no options for improvement, but still very slowly than with standard treatment (or rather, standard non-treatment).

Nadusha I C.B.

08.08.2010 21:20

And what kind of nursing departments and how to get there?

Anonymous

08.