Fecal Incontinence – Why me? What now?
By Linda Verde
“Well, here’s another nice mess you’ve gotten me into.” Odd that this quote from Oliver Hardy came to mind when there is nothing nice about the mess of fecal incontinence. It can be embarrassing and upsetting and often, because it is embarrassing, people keep it a secret and feel very alone. You are not alone! One in three people have fecal incontinence, two out of 100 children, and between 50 and 70 out of 100 adults in nursing homes. So, why did this happen to you?
It’s not because you were bad in a previous life! There may be more than one cause and tests can narrow it down. There are many reasons why you may have Fecal incontinence. Even smoking or having had your gall bladder out can be factors. What can be done?
Causes of Fecal Incontinence
- Laxative abuse
- Loss of rectal muscle power from injury or nerve damage
- Rectal prolapse or rectocele
- Physical inactivity,
- Childbirth by vaginal delivery,
- Birth defects such as Hirschsprung disease,
First, remember fecal incontinence is a medical problem—not a normal part of aging. It holds no shame. More importantly, it won’t go away by itself. Talking with your health professional is the first step. Be open and honest – the more information you can give, the better they can help you.
Several treatments do work.
Simple treatments—such as diet changes, medicines, bowel training, and exercises to strengthen your pelvic floor muscles (women and men)—can improve symptoms by about 60 percent. These treatments can stop fecal incontinence in 1 out of 5 people.
Dietary changes may help: avoiding things like coffee, prunes, cabbage, and other things that cause loose stool, and eating foods such as bananas, cheese, pasta and potatoes that thicken stool. For constipation, eat the things you avoid for diarrhea, drink lots of water and exercise – this advice is over-simplified; the National Institute of Health (NIH) provides more details.
Over-the-counter medicines such as Imodium, or on-the-shelf medicines like Pepto-Bismol can be taken for diarrhea, and things like colace (docusate sodium) or fibre supplements (e.g. Metamucil®) for constipation. Speaking with your doctor keeps you actively involved in your treatment. Be sure to check with a healthcare professional (e.g. pharmacist or nurse continence advisor) before using over-the-counter medications. Other medical treatment options involve surgeries, with some being more invasive than others.
Treatments aside, many people cope with fecal incontinence on a day-to-day basis.
Louise Mott, a founding member of The Canadian Continence Foundation, has lived with fecal incontinence for 14 years. She shares her story, lecturing around the world determined “to take away the taboo surrounding fecal incontinence and offer men and women sufferers the support they need . . . and want sufferers to know they are NOT alone.”
Strategies for Coping with Fecal Incontinence:
- Know where a bathroom is
- Go before you leave home;
- Wear absorbent pads or disposable underwear;
- Carry an extra set of clothes and clean-up supplies; use fecal deodorants; or,
- take anti-diarrheal medications before going out socially
Being actively involved in managing your fecal incontinence helps avoid embarrassing situations, and adds to your overall comfort and confidence. I believe quality of life is improved when there is at least some modicum of control (pun definitely intended).
Links to more information:
 Whitehead WE, Palsson OS, Simren M. Treating fecal incontinence: an unmet need in primary care medicine. North Carolina Medical Journal. 2016;77(3):211–215.