Bowel Incontinence (Fecal Incontinence)

What is Bowel Incontinence?

Bowel incontinence (fecal incontinence) is an inability to manage bowel movements and may include the accidental release of liquid stool or the complete inability to control bowel functions or hold discharge. While it can be an embarrassing and stressful condition, it is often treatable and is usually minimized with dietary changes or medication.

What are the Symptoms of Bowel Incontinence?

Chronic constipation, diarrhea, age-related changes to muscles, and nerve or muscle damage are some of the possible causes of bowel incontinence. The condition may also result if the rectum slips into the anus (rectal prolapse) or if the rectum penetrates the vagina (rectocele), although these are rare causes.

Symptoms include

  • Skin infection
  • Ulcer breakdowns
  • Anal itching

Possible risk factors

  • Injury or physical disability
  • Dementia-related conditions
  • Difficult childbirth
  • Chronic illness or poor health
  • General inactivity
  • Hemorrhoids

Passive and Urge Incontinence

Bowel incontinence can be classified as passive where one is not aware of the need to make a bowel movement. Urge incontinence occurs when there’s a sudden need to make a bowel movement without enough time to make it to a toilet.

Bowel Incontinence Causes

There is a myriad of causes which can contribute to the complex labyrinth which is the digestive system and its bowel control. Immediate, or even delayed, damage from childbirth is one of the most common reasons that BI may occur in a person. There is also a group of patients who experience this fecal incontinence due to the ramifications of an anorectal surgery, which is especially true when anal sphincters or hemorrhoidal vascular cushions are part of the operation. Also, irritable bowel syndrome, food intolerance, constipation with overflow incontinence, Crohn’s disease, and ulcerative colitis are all conditions which can lead to altered bowel habits and result in BI in the affected person.

The primary subgroups of people over the age of 18 all usually fall into one of the following cases: patients with structural anorectal abnormalities such as those resulting from sphincter degeneration, perianal fistula, or rectal prolapse, those with neurological disorders such as MS, spinal cord injuries, or stroke complications, those with constipation/fecal loading issues, cognitive and/or behavioral dysfunction, diarrhea, inflammatory bowel diseases and irritable bowel syndrome, disability related and those cases which are idiopathic. Finally, diabetes can also be an issue.

How is Bowel Incontinence Treated?

An anal manometry, (use of a balloon with sensors to test rectum sensitivity), an anal EMG (check of pelvic floor muscles and nerves), an anal ultrasound, and an MRI are some of the methods used to diagnose and identify the source of the problem.

Treatment includes

  • Bulk laxatives (Citrucel and Metamucil)
  • Anti-diarrheal medications
  • Pelvic floor exercises
  • High-fiber foods
  • Drinking more water
  • Avoiding fatty and greasy foods
  • Limiting alcoholic and caffeinated beverages

Approximately 20 million adults in the United States suffer from bowel incontinence, although it is more common among older adults and slightly more prevalent in women. Often a last resort, surgery may include repair of damaged muscles (sphincteroplasty) or creation of an artificial anal sphincter.

Bowel Incontinence Prevention

One common way to help prevent this disorder or to at least stop it from worsening is to perform Kegel exercises regularly so that the pelvic floor muscles and related ones will be strengthened in order to better support the bladder and the bowel. Dietary changes while keeping track of everything consumed is another way to help avoid the issue since some people have a linkage between certain foods and instances of BI. Adequate fiber is important, and so it should be checked regularly to insure that the diet has the necessary amount. Also, extra water usually has a good amount of benefits which includes many things as well as helping to regulate the bowel properly.