Fecal Incontinence

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• QWhat are the different types of accidental bowel leakage (ABL)?

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  A ABLinfo.org answered

  There are different types of accidental bowel leakage (ABL). ABL affects different people differently. Some people have ABL only when their stool is too loose; others have it when they are constipated. Some people lose stool and others lose mucus.
  
  ABL can happen with urgency, where someone is rushing to the bathroom and doesn’t make it in time, or it can happen without urgency, after a bowel movement. Sometimes ABL happens without a person even being aware of it.
  
  In most cases, ABL symptoms can usually be reduced or improved. Learning what you can do to improve symptoms can help people with ABL stay more active and increase well being.
• QWhat is fecal incontinence?

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  A NewYork-Presbyterian Hospital answered

  Fecal incontinence is characterized by an inability to control bowel movements, which may be caused by a number of conditions. Over 5.5 million Americans have fecal incontinence, which affects adults (more women and older adults), and children.

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• QHow does an artificial bowel sphincter work?

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  A Dr. Anthony L. Komaroff, MD , Internal Medicine, answered

  An artificial bowel sphincter is the only surgical option for fecal incontinence available in the United States for patients whose severe sphincter injury is beyond repair, or does not respond to other surgery. This procedure was approved by the Food and Drug Administration (FDA). The doctor inserts an artificial device that circles the anal sphincter (a circular band of muscle that surrounds and is capable of closing off the rectum). It keeps the anus closed until the patient squeezes a control pump to open it. The opening, in turn, allows a bowel movement to pass. For a male patient, the control pump is implanted in the scrotum. For a female patient, it is inserted in the labium. After being squeezed, the cuff gradually closes.

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• QWhat can I do if I have bowel incontinence?

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  A NewYork-Presbyterian Hospital answered

  See your doctor to determine the cause of bowel incontinence. Treatment will depend on the cause and severity of the condition, and may include medication, dietary changes, biofeedback, or surgery. Often more than one modality is used to treat bowel incontinence.

   

• QWhat lifestyle changes should I make if I have fecal incontinence?

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  A Reston Hospital Center answered

  If you have fecal incontinence, you can benefit from keeping your anal area clean and dry. Wash with plain water after every bowel movement, or use alcohol-free towelettes. Use a moisture-barrier cream, or non-medicated talcum powder, to relieve discomfort on the anal area. Wear loose-fitting, cotton clothing and underwear. Some people find disposable underwear or pads helpful, especially when out of the home. As your doctor about exercises (such as those for the sphincter) that might help your condition. Your doctor may also recommend trying a medication like loperamide in small amounts, depending on the cause of your condition; use only under medical supervision. Avoid foods that make your fecal incontinence symptoms worse. Eat plenty of fiber and drink plenty of water.

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• QHow can I improve my stool consistency if I have accidental bowel leakage?

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  A ABLinfo.org answered

  Stool consistency can make accidental bowel leakage (ABL) better or worse. If stools are liquid or loose, they are harder to hold onto (just like it is hard to hold water in your cupped hands). If stools are too hard, like little pebbles, they can slip out easily. It is easiest to control and eliminate stools that are well formed, like logs. 
  
  Fiber is an important part of achieving appropriate consistency, and it can be helpful in treating both diarrhea and constipation. When stools are too loose, fiber can absorb excess water to bulk up the stools and make them more formed. When you are constipated and stools are too hard, fiber can pull water into stools to make them softer -- but in that case, fiber has to be taken with plenty of water.
  
  A fiber diary can help you record your fiber, food and fluid intake as well as the impact of those things on your stool consistency. Fiber comes in lots of different forms, so you can experiment to find the sources of fiber that you enjoy. Some examples of high-fiber foods include kidney beans, navy beans, black beans, lentils, peas and artichokes. You can consult online sources to find the fiber content in these, and other, foods.
  
  Cereals and nutrition bars are good fiber sources as well, and you can check their nutrition labels for details about how much fiber they contain.  You can also take fiber supplements available over the counter if you don’t enjoy any of these food options.
  
  If stool remains loose even after supplementing with fiber, you may be able to use an over-the-counter antidiarrheal medication like loperamide (Imodium).
  
  If your stools remain hard even after supplementing with fiber and drinking plenty of water, you may be able to use a gentle laxative such as milk of magnesia or MiraLAX. You should not take both antidiarrheals and laxatives at the same time. If you cannot achieve your goal stool consistency with these lifestyle changes, ask your healthcare provider for help. He or she may recommend consultation with a specialist.
• QWhy should I keep a diary for accidental bowel leakage (ABL)?

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  A ABLinfo.org answered

  Accidental bowel leakage (ABL) is different for everyone, and for many people diet plays a role in triggering ABL. Tracking your diet, food and beverages with a diary can help you identify things that make your ABL better or worse.  You can use diaries to record the timing, frequency and consistency of bowel symptoms, as well as the timing of what you eat or drink.
  
  After you have completed diaries for one week, look over them to see if you recognize any patterns. For example, you may notice more accidents and looser stools after drinking caffeinated beverages, eating spicy or high fat foods, foods with artifiical sweeteners or after taking certain medications. Often people with ABL can begin to recognize a pattern.  Whether you do or not, keeping a food diary can be very helpful when you talk to a healthcare provider about this problem.
  
  In many cases, learning how to integrate fiber properly into your diet can be helpful. But fiber is not one size fits all. For people with loose stools and diarrhea, fiber helps by bulking up the stools so fiber does not need to be taken with lots of water. The goal with fiber when stools are loose is for the fiber to absorb the excess water in the stools and bulk up the stools (so taking fiber with lots of water can actually make the problem worse). When stools are hard and constipated, fiber is used to soften stools by pulling water into them. To soften stools, fiber needs to be taken with plenty of water. Learning how to use fiber to maintain better stool consistency often can make a big difference for people with ABL. 
• QWhat are the misconceptions about accidental bowel leakage (ABL)?

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  A ABLinfo.org answered

  A common misconception about accidental bowel leakage (ABL) is that many people think it is a disease and requires medical intervention. ABL is not a disease. It is a symptom associated with many common conditions and usually does not require medical intervention to improve symptoms. 
  
  Talking to your healthcare provider about ABL can help you learn how to improve symptoms. 90% of the time ABL is light to moderate and can be managed with dietary and lifestyle changes. Learning about how ABL affects you and what steps you can take to improve symptoms can help reduce ABL.
  
  Less than 10% of the time ABL requires medical intervention. Don’t be afraid to speak up about ABL with your healthcare provider.
• QHow does accidental bowel leakage (ABL) affect men?

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  A ABLinfo.org answered

  Many people mistakenly believe that accidental bowel leakage (ABL) is the result of childbirth and is a women’s health issue, but the truth is that ABL affects women and men.
  
  Many common conditions affecting both genders associated with ABL. Published research shows the most common causes and risk factors affecting both women and men are chronic irritable bowel syndrome (IBS), chronic diarrhea, diabetes, obesity and advancing age.
  
  It is true that childbirth and menopause are additional risk factors for women. And prostate therapy is a risk factor for men. ABL isn’t just a women’s health issue.

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• QHow common is fecal incontinence?

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  A Reston Hospital Center answered

  Fecal incontinence is quite common. Nearly 18 million Americans suffer from some form of fecal incontinence. Fecal incontinence is most often seen in women and the elderly, but it can happen to anyone, even children.

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