Embarrassing Bowel Leaks? You’re Not Alone

Living with fecal incontinence can be embarrassing and stressful. If you have this condition, you might avoid spending time in public, worried about when an accident might happen.

Most people have experienced a bit of bowel leakage at some point in their lives. However, if you regularly can’t control your bowel movements, you may have fecal incontinence. With this condition, accidents can occur at random times or happen when you sneeze, cough or exert yourself physically. This condition may also induce a sudden urge to use the restroom, with leakage occurring before you can reach the toilet.

Causes of Bowel Leakage

Fecal incontinence can be due to several causes, including:

• Rectal prolapse, which occurs when the rectum moves out of its normal position and protrudes through the anus or folds internally. This can cause stools to become trapped in the rectal wall.
• Weakening of the vaginal wall next to the rectal wall.
• Weakening of the pelvic floor.
• Weakened sphincter, possibly damaged during childbirth or pregnancy.
• Medical conditions such as inflammatory bowel disease.
• Previous surgery to pelvic area.
• Age. After you turn 65, you’re more susceptible.
• Certain disabilities, such as multiple sclerosis, Parkinson’s, spinal cord injuries, spina bifida or cerebral palsy.
• Prolonged constipation.

Nonsurgical Treatment Options

You’ll want to explore nonsurgical options first, depending on what’s causing your bowel leakage. These include:

• Taking an over-the-counter antidiarrheal agent to change your stool’s consistency.
• If your stools regularly get trapped, a fiber supplement to help you complete each bowel evacuation.
• Increasing your water intake to prevent constipation and keep stools soft, allowing them to pass more easily – reducing the risk of leakage.
• Using a special toilet footstool to change the angle that stools travel, making it easier for you to have complete bowel movements.
• If your bowel leakage is due to the weakening of pelvic muscles, then pelvic floor therapy can be helpful.
• If you also suffer bloating, gas and cramping, the cause might be irritable bowel syndrome, Crohn’s disease or ulcerative colitis. If you suspect any of these, make an appointment with a gastroenterologist to discuss next steps.

Surgical Options

Surgery is not a cure for fecal incontinence, but it can reduce your symptoms.

With sacral neuromodulation (SNM), a wire is implanted next to the nerve that stimulates the rectum. SNM stimulates that nerve continuously and can result in improvement of fecal leakage.

This surgery is less invasive compared to other options. Plus, the five-year success rate for patients who have had this surgery is 88%.

If your doctor conducts an ultrasound that clearly identifies sphincter damage, then a sphincteroplasty is an option. Your surgical team repairs the damaged anal sphincter. However, a sphincteroplasty has a lower success rate and has a difficult post-op recovery, and is not often recommended.

In some cases, the cause of your bowel leakage may be more complex. You may be a candidate for a bowel diversion, which reroutes the flow of feces, or a colostomy. Talk to your urogynecology surgeon to explore these options.

No matter which option you choose, know that you are not alone. More than 8% of the population struggles with this issue. In addition to seeking medical help, you may want to talk to a therapist. This condition can be emotionally challenging, and you don’t have to live with it in silence.