CONDITIONS A-Z

Bowel Incontinence

Bowel incontinence is leakage of some kind from the bowel, or uncontrollable gas or flatulence that isn't caused by a one-time incident or infection and is repeated or continuous over an extended period of time.

Some people have symptoms such as a little bit staining of their underwear from time to time. Some people pass a lot of gas without knowing.

Others find themselves urgently running for the toilet. Some people are careful to ensure that they know where the toilets are when they go out. This is called toilet mapping.

Some people need to wear continence aids, such as absorbent pads.

Why does it occur?

Women who have had children by vaginal birth, older people (up to 25% of those living in care1), and people who've had trauma, such as an accident or surgery or a stroke, can have bowel incontinence.

Conditions such as diabetes or Parkinson's disease can also cause bowel problems. And people who have an inflammatory bowel disease or irritable bowel syndrome can find themselves running for the toilet or having some leakage.

Bowel incontinence is not an inevitable consequence of having had children. It's not a normal part of ageing.

How common is it?

Studies suggest that in the UK "major faecal incontinence" affects 1.4% of the general population over 40 years old and constipation affects between 3% and 15% of the population.2

How can it be treated?

Each type of incontinence requires specific treatment approaches. A healthcare advisor will assess the condition and help patients to decide what treatment and management options to take.

Diet and exercise

Some people find that their diet has an effect on their toilet habits. Getting advice from a dietitian on what might affect the bowel can be helpful.

If a patient has muscle weakness, exercises will be recommended to strengthen the pelvic floor muscles and anal sphincter muscles.

It’s quite common for people to be unaware of the muscles of the pelvic floor. There are a variety of methods to help you raise your sensitivity to these muscles, such as mild electrical stimulation.

Biofeedback

Biofeedback is a technique used when exercising that measures your muscle contractions as you do them.

Mild electrical stimulation is sometimes used to complement and enhance these exercises.

Behavioural therapy

Patients might also benefit from behavioural therapy, which can mean adapting to a particular regimen that help to attain predictability in bowel habits.

Medicines

Medicines can help relieve some symptoms and increase muscle tone. They might be recommended to complement other treatment options.

Nerves

Electrical stimulation of the nerves that pass through the lower back can help control muscle reactions, reflexes and sensations. It is called sacral neuromodulation. It is also effective for dual incontinence.

Surgery

Surgical options are available to those who need them. For instance, those people who have tried other therapies that haven't worked or are poorly tolerated.

Surgery can also fix or alleviate muscular damage or slippages in the structures or organs in your pelvic and bladder area.

Continence aids

There are many continence products available. Designs and materials as well as product choice and performance have improved in recent years. These products aid skin care, leakage management and other aspects of continence care.

Incontinence Web Chat

Mr Andrew Clarke, Colorectal Surgeon, from Poole Harbour BMI Hospital joins us live online at http://webchats.tv/chat/take_control_of_incontinence on Thursday 10th December 2009 at 14.00 to discuss bladder and bowel problems and the potential treatments to cure this common issue.

References:

1. Royal College of Physicians. (23.11.2005) Inadequate and Incomplete – Continence Care in the UK. Press release http://www.rcplondon.ac.uk. (Accessed 10.10.2006)

2. Jarret, M.E.D. et al. Systematic review of sacral nerve stimulation for faecal incontinence and constipation. British Journal of Surgery 2004; 91: 1559-1569. http://www3.interscience.wiley.com/cgi-bin/abstract/109630867/ABSTRACT?CRETRY=1&SRETRY=0. (Abstract available. Article accessed 21.12.2006)

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