How can I control bowel incontinence?

DEAR DOCTOR K:

Sometimes my bowel movement leaks onto my undergarments. What can I do to control this?

DEAR READER:

Take heart — you are not alone. Depending on how fecal, or bowel, incontinence is defined, some studies have found that 10 percent or more of adults in the United States (not including people living in institutions) have this condition. And there are many things you can do to prevent it.

If your bowel movements tend to be loose and watery, and come frequently, start with some changes to your diet. For example, specific foods may be triggering your diarrhea. Try cutting out or reducing these common triggers:

  • cured or smoked meats
  • spicy foods
  • fatty and greasy foods
  • fruits
  • dairy products
  • alcohol
  • caffeine
  • sweeteners such as sorbitol, xylitol, mannitol and fructose (found in many diet drinks, fruit drinks, sugarless gums and candies).

Take a daily fiber supplement. This is one of the most effective ways to reduce fecal leakage. Over-the-counter products like Metamucil or Citrucel are found in any drugstore. More recently, tasteless powdered fiber supplements have become available over-the-counter in drugstores as well. They dissolve more completely in liquids and can be added to any hot or cold liquid you drink — and you won’t know they’re there. Several of my patients tell me they’ve had great results.

Drink plenty of liquid with the fiber supplement to help control diarrhea. This may seem counterintuitive, but the fiber absorbs the water and prevents leakage of watery stool.

Your medications could also be contributing to your diarrhea and incontinence. Discuss all of your medications with your doctor.

Your doctor may suggest an anti-diarrheal medicine. Loperamide (Imodium) has the added benefit of increasing muscle tone in the internal anal sphincter.

You can further strengthen the muscles of your pelvic floor, including the anal sphincters, with specific exercises. Biofeedback can help you learn to do the exercises correctly.

Biofeedback can also improve your ability to sense the presence of stool in your rectum. This, in turn, may allow you to get to a bathroom before the situation becomes desperate.

Another form of biofeedback delivers a small electrical shock to your anal sphincter. This produces muscle activity that bulks up the sphincter muscles. Yes, it sounds a little weird, but it works.

We have more information on bowel incontinence in our Special Health Report, “Better Bladder and Bowel Control.” You can learn more about it here.

Talk to your doctor about which of these treatments might work best for you.