If you’ve experienced accidental bowel leakage, you’re not alone.
Up to 18 percent of the general population suffer from an involuntary loss of gas or solid or liquid bowel movements. The percentage, however, is likely much higher. That’s because many people are too embarrassed to talk about their symptoms.
People with accidental bowel leakage, also called fecal incontinence, often avoid social events or long trips in a car.
They might be nervous about taking a new job or entering a romantic relationship. Because they’re so reluctant to get help, fecal incontinence has been called “the silent affliction.”
However, knowing your risk factors and seeking treatment can significantly improve your quality of life.
Accidental bowel leakage is more common among women, in part due to childbirth. Up to 11 percent of women who give birth vaginally may experience fecal incontinence. During delivery, the anal muscles and tissue might stretch or tear. There might be damage to the anal sphincter, the muscle group that controls the stool’s release, and the pudendal nerves, which control the anal muscles. The risk is higher if the birth required forceps, a vacuum or an episiotomy.
The most apparent symptoms include an inability to control gas or the accidental loss of a stool—either without warning or with an overwhelming urge to move your bowels. It may happen when you laugh or cough. You may note staining on your underwear but never felt the urge to go to the bathroom. Some people have the symptoms intermittently. Others have them every day.
Many people experience accidental bowel leakage during a bout of flu or food poisoning. But if it affects your lifestyle and your relationships, it’s time to call your health care provider.
Your health care provider will ask questions about your health and lifestyle and conduct a thorough examination.
Tests include an anorectal manometry, which checks the strength of your anal sphincter. Health care providers at ChristianaCare Center for Urogynecology and Pelvic Surgery can perform this test in the office.
An anal ultrasound provides an image from inside the rectum. You may also need a colonoscopy if you’re due for one. Other imaging may be helpful as well.
The treatment will depend on the underlying cause.
To start, your health care provider will suggest a diet and an eating schedule to firm up your stools. Eating at regular times can help regulate your bowel movements. You may need to avoid foods that trigger diarrhea. You may also need medication for diarrhea or constipation.
Physical therapists at ChristianaCare who specialize in the pelvic floor area can help you strengthen your pelvic floor muscles and anal sphincter. The PT provider may use biofeedback and stimulation therapy.
You’ll also learn how to do Kegel exercises to strengthen the muscles around the openings of the anus, urethra and vagina. (Women ideally should practice these exercises before giving birth.)