Fecal Incontinence

By: Karen Bang, PT

Going to the bathroom for a bowel movement is something that we all do regularly, but don’t often talk about, especially when one is struggling with fecal incontinence issues. Many of us understand the importance of a healthy bowel regimen and know that you should not ignore an urge to go. But have you ever found yourself in a situation where it was not possible to access a bathroom? Maybe you were on the road and the next highway exit was 10 minutes away. Or maybe you were on a hike and there was no bathroom in sight. In these scenarios, we would be forced to control our urge. It can be hard sometimes, but we are most often successful at waiting until we reach a bathroom.

However, some people may find themselves with an urge to have a bowel movement in a car or on a hike and not be able to wait. Fecal incontinence (FI) is described as the involuntary loss of feces during inappropriate times or places. About 2-25% of the population experience fecal incontinence.

What are some risk factors for experiencing FI?

Age – FI can occur at any age, but is more common in the older population. As we age, our anal sphincter muscles can begin to atrophy and our mobility may affect how quickly we are able to access a toilet.

Gastrointestinal symptoms and disorders – Having irritable bowel syndrome or certain food sensitivities can often lead to looser stools, increased urgency, and inconsistent frequency of bowel movements.

Obstetric factors – Those who experience more severe tearing during delivery can result in lacerations of their anal sphincter muscles.

Certain surgical procedures – These can include having a colectomy, radical prostatectomy, or pelvic radiotherapy.

What are several things to consider if you are experiencing FI?

Diet – fibre is great at regulating your stool consistency and you may not be getting enough fibre from your diet. Adding a fibre supplement to your diet can often significantly reduce your FI symptoms.

Water intake – ensuring that you are drinking enough liquids is an important step when considering bowel health.

Physical activity – exercising is a fantastic way to get you gut and bowels moving! Being sedentary can contribute to a slowing down of your digestive system, making it harder to pass your stool and can lead to incomplete emptying of your bowels. Being able to have healthy and full bowel movements will reduce your chances of experiencing unwanted leakage of feces at undesired times.

Medication side effects – being aware of the side effects of your medications, supplements, and natural remedies is very important. A number of things that we ingest can have an impact on our gastrointestinal system including increasing symptoms of diarrhea or constipation.

Functional incontinence – functional incontinence is the term used to describe the occurrence of incontinence when one does not reach a toilet in time secondary to an obstacle or a disability. An example would be if someone had reduced mobility and were not able to climb up the stairs in a timely manner to access the washroom, resulting in episodes of incontinence. A possible solution to this problem would be to place a transportable toilet chair (commode) closer to the person with mobility issues.

Make an appointment today with one of our pelvic health physiotherapists so they can help you identify the contributing factors to your FI and explore a variety of treatment options including urgency management, evacuation re-training, and muscle training.

References:

https://pubmed.ncbi.nlm.nih.gov/18096041/

https://pubmed.ncbi.nlm.nih.gov/25320568/

https://pubmed.ncbi.nlm.nih.gov/20025031/

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