Understanding Bowel Incontinence: Causes and Treatment Options
Bowel incontinence, also known as fecal incontinence, is the unintentional loss of stool or gas. While it’s a sensitive topic, it’s more common than you might think, affecting people of all ages. This condition can significantly impact quality of life, leading to embarrassment, anxiety, and social withdrawal. However, effective treatments are available, and physiotherapy plays a crucial role in managing symptoms. In this blog, we’ll explore the causes, symptoms, and treatment options for bowel incontinence.
What is Bowel Incontinence?
Bowel incontinence occurs when there is a loss of control over bowel movements, leading to unexpected leakage of stool or gas. It can range from occasional leakage to a complete inability to control bowel movements. The severity and frequency of symptoms vary depending on the underlying cause.
Common Causes of Bowel Incontinence
Several factors can contribute to bowel incontinence, including:
Muscle Damage
Injury to the anal sphincter muscles, which control bowel movements, can lead to incontinence. This is often due to childbirth, particularly after a difficult delivery or the use of forceps.
Nerve Damage
Nerve damage can impair signals between the brain and the bowel. Conditions like diabetes, multiple sclerosis, and spinal cord injuries can contribute to this.
Chronic Constipation
Chronic constipation can weaken the muscles and nerves in the rectum, leading to overflow incontinence, where loose stool leaks around impacted stool.
Diarrhea
Frequent, loose stools are harder to control and can increase the risk of incontinence. Diarrhea may result from gastrointestinal infections, irritable bowel syndrome (IBS), or food intolerances.
Rectal Prolapse or Surgery
A rectal prolapse (when the rectum protrudes from the anus) or surgical procedures in the pelvic area can damage muscles and nerves, affecting bowel control.
Age and Muscle Weakness
As we age, the pelvic floor muscles and anal sphincter may weaken, making it harder to control bowel movements.
Symptoms of Bowel Incontinence
Inability to control bowel movements, leading to unexpected leakage.
Frequent urge to pass stool with little warning.
Passing gas unexpectedly.
Constipation followed by sudden diarrhea.
Discomfort or irritation around the anus due to leakage.
Diagnosis
Diagnosing bowel incontinence typically involves:
Medical History and Physical Examination: To understand symptoms, medical history, and any underlying conditions.
Anal Manometry: Measures the strength of the anal sphincter muscles.
Endoanal Ultrasound: Visualises the anal sphincter muscles to check for any damage.
Colon Examination (Colonoscopy or Sigmoidoscopy): Rules out any structural issues or abnormalities in the colon.
Treatment Options
Treatment depends on the underlying cause and severity of symptoms. Here are some effective approaches:
1. Lifestyle and Dietary Changes
Increase fiber intake to regulate bowel movements.
Drink plenty of water to maintain hydration.
Avoid foods that trigger diarrhea or gas, such as caffeine, spicy foods, and artificial sweeteners.
2. Medications
Anti-diarrheal Medications: To firm up stool and reduce urgency.
Laxatives: For constipation-induced incontinence, to regulate bowel movements.
Bile Acid Sequestrants: To manage diarrhea caused by bile acid malabsorption.
3. Physiotherapy and Pelvic Floor Exercises
Pelvic Floor Muscle Training: Strengthening the pelvic floor muscles can improve bowel control. Physiotherapists guide patients through exercises that target the anal sphincter and pelvic floor muscles.
Biofeedback Therapy: Helps patients learn how to control pelvic floor muscles using visual or auditory feedback.
Rectal Balloon Training: Improves sensory awareness and control over bowel movements.
4. Bowel Retraining
Establishing a regular toilet routine helps train the bowel to empty at specific times, reducing accidents.
5. Surgical Interventions (in severe cases)
Sphincteroplasty: Repairs damaged anal sphincter muscles.
Sacral Nerve Stimulation: A device is implanted to stimulate nerves that control bowel function.
Colostomy: In extreme cases, a colostomy may be performed to reroute stool through an opening in the abdomen.
How Can Physiotherapy Help?
Physiotherapists play a crucial role in managing bowel incontinence by:
Assessing pelvic floor muscle strength and function.
Designing customised exercise programs to strengthen pelvic floor and anal sphincter muscles.
Teaching relaxation techniques to reduce anxiety associated with incontinence.
Educating patients about bowel habits and dietary changes to improve bowel regularity.
Living with Bowel Incontinence
Bowel incontinence can be challenging, but it is manageable with the right approach. Besides medical treatment, adopting practical strategies can enhance daily life:
Use absorbent pads for added confidence.
Carry a change of clothes when traveling.
Practice mindfulness and stress management techniques to reduce anxiety.
Seek emotional support from counselors or support groups.
Conclusion
Bowel incontinence is a common condition that significantly impacts quality of life. However, with the right diagnosis and treatment plan, including physiotherapy, symptoms can be managed effectively. If you’re experiencing bowel incontinence, don’t hesitate to reach out for help. Our physiotherapy team specialises in pelvic floor rehabilitation and is here to support your journey to improved bowel health and confidence.
Our Director, Aileen Maguire, leads the pelvic floor rehabilitation service at the clinic, treating both male and female patients with bladder and bowel incontinence, as well as pelvic pain.
Bowel Incontinence Service
Physiotherapy for bowel incontinence focuses on strengthening the pelvic floor muscles, improving coordination, and enhancing bowel control through tailored exercises and lifestyle modifications.