You Can Improve Accidental Bowel Leakage

How to take back bowel control

Woman looking in mirror

If you experience accidental bowel leakage, don’t shy away from talking about it.

It’s not the most pleasant of topics — or experiences — but it is also much more common than you might think. For example, in a 2012 study, nearly 19 percent of women surveyed reported an episode of accidental loss of gas or stool. This is actually higher than previous numbers reported in other studies.

You can take steps to control accidental bowel leakage. Start by understanding whom it affects — as well as what treatments are available.

Accidental bowel leakage affects many

The study above focused on women, but we see a wide variety of patients with accidental bowel leakage. It affects men and women who have chronic diarrhea. It affects the aging population because the muscles involved in bowel control weaken over time. It also affects many women after childbirth — particularly those with an injury to the muscles and nerves in the pelvic floor.

“Be your own health advocate by asking about these advanced options. When conservative treatment fails, advanced therapy can change your life for the better.”

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Brooke Gurland, MD

Department of Colorectal Surgery

Sometimes there are unexpected causes, too. For example, both hemorrhoids and rectal prolapse — a condition in which the lower part of the bowel extends outside the anus — can cause leakage. In these cases, your doctor will need to treat the underlying issues rather than the leakage itself.

In other words, it’s critical to seek a proper diagnosis so you can find the right solutions.

Treatment starts with conservative options

For example, many people improve simply from treating diarrhea with antidiarrheal medications or taking probiotics to improve gut health. In addition, taking fiber to “bulk up” your stool can be helpful. However, if your diarrhea is chronic and frequently leads to an accident, your doctor needs to know. It could be a sign of a deeper problem, such as inflammatory bowel disorder.

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For structural issues such as injuries after childbirth, we often recommend Kegel exercises. This series of exercises relaxes and contracts the pelvic floor muscles that are responsible for bowel control. In fact, these exercises are often helpful for women before giving birth to help prepare their bodies and, ideally, avoid accidental bowel leakage later.

Advanced options are available

When the cause of accidental bowel leakage is more severe — such as damaged muscles and nerves — we have to treat it more aggressively.

The good news is that there are more minimally invasive options than ever. In the most severe cases, people need surgery to repair damage to the sphincter and nearby muscles. But a growing population of patients with accidental bowel leakage can be treated without surgery. Options include:

  • Solesta, an injection that bulks the anal canal and decreases bowel leakage
  • Secca, a simple electrical stimulation procedure that results in tissue contractions that strengthen the anal muscles.
  • Interstim, a “pacemaker” device  we implant to stimulate the nerves of the lower back that sense an imminent bowel movement — and help you hold it. Interstim also helps treat urinary incontinence.

I bring up all of these options for a simple reason: Many are relatively new, and not all doctors are aware of them.

If accidental bowel leakage is taking a toll on your quality of life, don’t be afraid to talk to a doctor — and be your own health advocate by asking about these advanced options. When conservative treatment fails, advanced therapy can change your life for the better.

Download Our Free Bowel Disorders Treatment Guide

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Brooke Gurland, MD

Brooke Gurland, MD, is a surgeon with the Department of Colorectal Surgery at Cleveland Clinic.
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