Bowel (Fecal) Incontinence: Symptoms, Causes and Treatment
Bowel incontinence, also known as anal or fecal incontinence, is the term used when bowel movements cannot be controlled. Stool (feces / waste) discharges out through the rectum at unwanted times. Bowel incontinence is more common in women than men and also in the older people.
Two types of bowel incontinence are:
- Urge bowel incontinence- When the person suddenly wants to go to the toilet to pass stool but can't make it on time.
- Passive bowel incontinence- When the person is unaware and nothing indicates that a bowel movement is about to occur.
The term bowel incontinence is used when one of these situations occurs:
- Stool leaks when gas is released.
- Stool leakage due to physical activity/daily activities.
- You feel like you have to go to pass stools and can't get to the bathroom on time.
- Stool is seen in underwear after a normal bowel movement.
- There is a complete loss of bowel control.
Who is at risk for Bowel Incontinence?
Anyone can suffer from bowel incontinence, but some people get it more often than others. The following are more at risk-:
- People over 65 years old
- Woman who has given birth
- People with chronic constipation
- Those having an injury or disease that causes nerve damage
Symptoms of Bowel Incontinence
Fecal or Bowel incontinence can be both, a short-term problem or one that occurs regularly. The word ‘bowel incontinence’ itself describes the issue but it is not all, it has few more symptoms, as it is not just a single health problem but a cluster of health issues, few of these symptoms are as follows
- Loose, watery stools (diarrhea)
- Mucus along with the stools
- Irregular bowel movements (constipation)
- Abdominal discomfort and bloating
- Abdominal pain or cramps
- Itching and inflammatory irritation in the anal region
What causes Bowel Incontinence?
Normal bowel movement depends on the proper functioning of the:
- Pelvic muscles
- Rectum, lower end of the large intestine
- Anal muscles
- Nervous system
Injury to any of these areas can cause fecal incontinence.
Common causes of fecal incontinence are:
If the nerve that control sphincter movement of anal region is damaged, the sphincter will not close properly which will lead to involuntary movement of bowel through anal region.
Some of the causes of nerve damage are-
- Birth trauma
- Chronic constipation
- Multiple Sclerosis (MS)
Diarrhea is loose or watery stools. This loose stool can cause an immediate bowel movement. The urge can be so sudden that you don't have enough time to go to the washroom.
External piles can block the complete closure of the sphincter. This allows involuntary passage of stool all the time.
Pelvic floor dysfunction-
In women, excessive pressure on pelvic floor muscles during labor may cause damage to the sphincters and tone of pelvic floor muscle, leading to muscle weakening, which can cause bowel incontinence, urinary incontinence, and rectal prolapse.
Treatment for Bowel Incontinence
Bowel incontinence can be an uncomfortable condition, but it can be improved with treatment or medication.
Dietary changes- Preventing recurrent diarrhea and constipation is usually very helpful in controlling fecal incontinence. Changes in your diet, such as adjusting the amount of fiber you eat or drinking more fluids can often prevent diarrhea and constipation.
Medications-Your doctor may prescribe laxatives, anti-diarrhea medications, or stool softeners to treat fecal incontinence. Talk to your doctor before taking over-the-counter medications.
Bowel exercise-Developing a regular pattern of bowel movements can be very helpful. This may include going to the bathroom at certain times of the day, e.g. after meals or a treatment called anorectal biofeedback. This procedure measures the contraction of your sphincter muscles when you perform special exercises called Kegel exercises. Biofeedback training can strengthen your sphincters and give you more control over your bowel movements.
Surgery-Fecal incontinence can be treated with a variety of surgical procedures. Often this operation restores or replaces the sphinctermuscles.
Yoga or pelvic floor exercise-Regular exercise of pelvic floor muscle or yoga will help in regaining the pelvic floor muscle tone or sphincter health which will reduce the symptoms of bowel incontinence.
What should I avoid if I have Bowel Incontinence?
If your stool/bowel incontinence is caused by diarrhea, it's best to avoid foods that make your symptoms worse, such as-
- Alcoholic beverages
- Caffeinated drinks and food
- Dairy products such as milk, cheese and ice cream
- Fatty food
- Drinks and foods that contain fructose
- Fruits like apples, peaches and pears
- Spicy food
When to see a doctor?
If you notice a change in bowel control, you should visit your doctor. Most people feel restless when discussing bowel movements, gas, or stool but doctors understand that this is very normal and can be treated by taking necessary precautions.