Bowel control problems aren’t as rare as you might think.
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Nearly 18 million U.S. adults have difficulty controlling their bowels, a condition called fecal incontinence.
Yet many people with this condition don’t seek help because they’re too embarrassed or aren’t sure where to turn.
Fecal incontinence is the accidental passing of solid or liquid stool or mucus from the rectum. You might be unable to hold a bowel movement until you reach a toilet or might pass stool into your underwear without being aware of it.
More common in older adults
People of any age can have a bowel control problem, though fecal incontinence is more common in older adults. The condition is slightly more common among women.
These conditions can increase your risk of developing fecal incontinence:
- Diarrhea, which is the passing of loose, watery stools three or more times a day.
- Urgency or having very little time to get to the toilet for a bowel movement.
- A disease or injury that damages the nervous system.
- Poor overall health from several long-lasting illnesses.
- Going through a difficult labor that injured your pelvic floor. The pelvic floor is the muscles, ligaments and tissues that support the uterus, vagina, bladder and rectum.
“Many people suffer unnecessarily with fecal incontinence because they feel embarrassed,” says colorectal surgeon Massarat Zutshi, MD. “But if someone does have a bowel control problem, they should bring it up to their health care provider or find a specialist in their area.”
Certain medications often cause diarrhea, leading to fecal incontinence, says Dr. Zutshi, who sees patients at Cleveland Clinic’s Colorectal Center for Functional Bowel Disorders. But effective treatments to reduce or eliminate symptoms are readily available, she says.
“Recent advances in medical devices have given us more effective options to treat this benign yet debilitating disorder,” Dr. Zutshi says.
Doctors diagnose fecal incontinence based on your medical history, a physical exam and specific test results.
Sometimes, simple changes can improve the symptoms of fecal incontinence, Dr. Zutshi says. Such changes might include slowly adding more high-fiber foods such as fruits, vegetable, whole grains and beans to your diet.
Another simple change is to make sure you are drinking plenty of liquids every day — Dr. Zutshi recommends eight 8-ounce glasses of water. Drinks that contain caffeine, carbonation or milk can cause diarrhea, Dr. Zutshi says.
Another simple way to improve the symptoms might be to stop taking certain medicines that might cause fecal incontinence.
If these simple changes aren’t effective, your physician may recommend treatment that involves several therapies. These therapies might include:
- Medicine — Anti-diarrhea drugs can decrease frequency of intestinal spasms or reduce the stool’s water content to make it firmer. Some medicines combine the two actions.
- Biofeedback — You can strengthen and coordinate your pelvic floor muscles by squeezing and relaxing them every day. Biofeedback can help you establish the proper technique. Depending on the cause of fecal incontinence, doctors also can use biofeedback to heighten your awareness of what the rectum feels like when it’s filling with stool.
A doctor may recommend surgery if other treatments don’t help or injury is causing the fecal incontinence. Surgery options include:
- Sphincter repair — A surgical procedure that repairs a damaged or weakened anal sphincter, which is the muscle that surrounds the anus.
- Artificial bowel sphincter — An implantable device that can replace a damaged sphincter.
- Injection therapy — Injecting a silicone-based filler into the anal sphincter may improve fecal incontinence by increasing the anal sphincter’s size.
- Sacral nerve stimulation — Implanting a pacemaker under the skin in the upper buttock area aids continence by transmitting mild electrical impulses through a lead wire close to the sacral nerve.
- SECCA procedure — A minimally invasive treatment using radiofrequency stimulation to promote collagen deposition in the anal sphincter.