Specific foods may trigger diarrhea in some people. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has identified a number of foods you might try eliminating from your diet to see if your symptoms improve. According to the NIDDK, potential sources of trouble include caffeine, cured or smoked meats, spicy foods, alcohol, dairy products, fruits, fatty and greasy foods, and sweeteners (such as sorbitol, xylitol, mannitol, and fructose) that are found in many diet drinks, fruit drinks, sugarless gum, and candies.
Your physician may advise a change in the medications you take for other conditions, in case they are contributing to diarrhea and incontinence problems. As an example, the antidiabetic drug metformin (Glucophage) sometimes results in chronic diarrhea, long after starting the drug. Orlistat (Xenical), a medication used to treat obesity, decreases the absorption of fat from the digestive tract. Side effects may include several distressing bowel symptoms, including oily seepage from the rectum, fecal urgency, and, for a few people, fecal incontinence.
If food seems to move through your digestive system rapidly, your doctor may suggest an antidiarrheal medicine such as loperamide (Imodium) or diphenoxylate and atropine (Lomotil). This can solidify your stools and make them less frequent. Loperamide has the side benefit of increasing muscle tone in the internal anal sphincter, which can also help with incontinence. Another medication, the tricyclic antidepressant amitriptyline, also reduces the number of bowel movements. Some doctors have used it successfully to improve fecal incontinence, although the effectiveness of this treatment has not yet been confirmed in a controlled study.