Fecal incontinence is the medical term for when a person loses control of his or her bowels. A person with fecal incontinence might leak solid or liquid bowel movements. The term “anal incontinence” includes these issues as well as the leaking of gas.
Fecal incontinence is most common in women who had 1 or more babies when they were younger. It happens because the muscles that control bowel movements can get damaged in childbirth. Men can also have fecal incontinence for other reasons.
Having fecal incontinence can be embarrassing and stressful. People who have it sometimes stay at home instead of going out, because they are afraid of having “an accident.” If you have trouble controlling your bowels, you should know that the problem is not a normal part of aging. It can often be treated and fixed, or at least improved.
Yes. Your doctor will look at your anus and do a “digital rectal exam.” During a digital rectal exam, your doctor will put a gloved finger into your anus and rectum to feel for lumps or anything abnormal. Doctors can also do a few different tests to find out what might be causing fecal incontinence. Your doctor might order one or more following tests:
- Colonoscopy or sigmoidoscopy – During a colonoscopy, the doctor puts a thin tube into your rectum and advances it up into your colon. The tube has a camera attached to it, so the doctor can look inside your large intestine and take tissue samples (called biopsies). A sigmoidoscopy is very similar, but the tube does not go in as far.
- Manometry – Manometry permits the doctor to measure the pressure within the rectum at various points. It can help the doctor determine if the muscles that control gut movements are working right. The check also shows whether or not the person’s rectum can feel normally.
- Ultrasound or MRI – Ultrasound and MRI are imaging tests. They can also help the doctor check whether the muscles that control bowel movements are normal.
- Bowel movement tests – Doctors sometimes check a sample of bowel movement for infections that could cause diarrhoea.
Yes. Some people have fewer problems with fecal incontinence if they:
- Avoid foods and drinks that cause loose or frequent bowel movements. Examples include:
- Dairy foods (for people who have trouble with dairy)
- Spicy foods
- Fatty or greasy foods
- Drinks with caffeine, such as coffee
- Diet foods or drinks
- Sugar-free gum or candy
- Eat smaller meals, more often. In some people, eating a large meal generates the urge to have a bowel movement. It can also cause diarrhoea. Eating smaller and more frequent meals can reduce the number of bowel movements you have.
- Eat more fiber. Fiber makes bowel movements bulkier and sturdier. This can make bowel movements easier to control. Foods that have a lot of fiber include fruits, vegetables, and whole grains. You can also get more fiber by taking fiber supplements, such as Metamucil, Citrucel, or Benefiber.
Yes. If you have fecal incontinence, tell your doctor. People are sometimes too shy to bring it up. But fecal incontinence is a real medical issue that can be treated.
Treatments your doctor might suggest include:
- Fiber pills, powders, or wafers – Fiber supplements make bowel movements bulkier and sturdier. This can make bowel movements easier to control.
- Medicines to reduce the number of bowel movements – These medicines are often used to treat diarrhea. They can decrease the number of “accidents” a person has. Examples of these medicines include loperamide (sample brand name: Imodium) and diphenoxylate-atropine (brand name: Lomotil).
- Medicines to slow the movement of food through the intestines – These medicines are called “anti-cholinergics.”
- Treatment to empty the bowels – Some people with fecal incontinence have constipation and that they cannot empty the bowel completely. These people need treatment to flush the bowels. Then, once the bowels are cleaned out, they can take medicines to keep bowel movements regular.
- Scheduled bathroom visits – Some people have fewer accidents if they visit the bathroom on a schedule. They try to go even when they don’t “feel” like they need to go.
- Biofeedback – Biofeedback is a way to retrain the muscles that control bowel movements. It is done at the doctor’s place and involves using devices called sensors that measure muscle activity. These sensors tell you if you are using the muscles the right way.
- Electrical nerve stimulation – Doctors can implant devices that send a mild electrical current to the nerves that control the muscles in the anus. These devices sometimes help improve bowel control.
- Surgery – Doctors can sometimes do surgery to repair the muscles that control bowel movements. This is often helpful in women whose muscles were damaged during childbirth. There are also other types of surgery to treat fecal incontinence.