Fecal incontinence

Incontinence is generally associated with loss of bladder control, but incontinence can also mean leakage of stools. While fecal incontinence is more common in the elderly, adults and children can also be affected.

Fecal incontinence is the inability to control bowel movements, causing incontinence or leakage of feces or gas. Many of the people suffering from fecal incontinence also suffer from urine leakage, also known as double incontinence. Precise statistics for fecal incontinence and double incontinence are difficult to determine. This is mainly due to the taboos surrounding incontinence and fecal incontinence in particular.

 

What causes fecal incontinence?

Fecal incontinence occurs when the sphincter muscle is no longer able to hold the feces. The most common cause of fecal incontinence is damage or weakening of the anal sphincter muscle. In addition, damage to the nerves that control the anal sphincter muscle and the pelvic floor can lead to lack of urge to go to the toilet. This damage can be caused by surgery, childbirth or congenital disease. Fecal incontinence may also be caused by constipation, haemorrhoids or rectal prolapse. People with dementia, over 65, or with certain diseases, such as nerve damage, diabetes and multiple sclerosis, have an increased risk of developing bowel incontinence

There are however many treatments available to improve fecal incontinence and quality of life, so it is important to seek help from health care professionals in time.

Fecal incontinence in children

Even though fecal incontinence occurs more often in elderly people, it can also happen to children. Especially children and (young) adults with physical and/or mental disabilities suffer from fecal incontinence due to a poorly functioning sphincter muscle. Children with a non-congenital brain disease such as Parkinson’s disease or brain damage due to an accident, may struggle with fecal incontinence or double incontinence. 

IBS (Irritable Bowel Syndrome) and Morbus Crohn

In addition to people with disabilities and elderly people, fecal incontinence occurs in people with a bowel disease. IBS (Irritable Bowel Syndrome) is a disease without a specific cause for the bowel problem, flatulence and diarrhea. Some of them also deal with fecal incontinence.

Morbus Crohn is sometimes connected to loss of bowel control. In Morbus Crohn there is an inflammation in the small bowel, large bowel and/or the anus.

Obstipation and overflow-diarrhoea

Fecal incontinence can also result from obstipation. Obstipation is a severe form of constipation in which a person has difficulties emptying the bowel properly. In the long term, obstipation leads to hard feces and obstipation in the bowels. Sometimes, very soft, liquid feces are able to pass through.  As soft stool is more difficult to control, loss of bowel control occurs. This kind of fecal incontinence is also called overflow diarhoea or paradox diarrhea.

Solutions for fecal incontinence

Depending on the cause of fecal incontinence, there are several solutions. In case of fecal incontinence, it is always recommended to consult a physician or specialist who can recommend lifestyle changes, incontinence products, medication, surgery for the recovery of the sphincter muscle or, in severe cases, an ostomy.

Tips for treatment of fecal incontinence

Tip 1: As with involuntary urine leakage, fecal incontinence can also be reduced or completely eliminated with pelvic floor exercises and physiotherapy. A pelvic floor physiotherapist can give advice.

Tip 2: If obstipation is the cause, lifestyle adjustments can provide symptom relief. Consuming dietary fibers (i.e. cereals, vegetables and fruit) and at least 2 litres of liquids per day can make a big difference. Furthermore, sufficient exercise and sufficient time for toilet visits can give a fast result.

If adjusted lifestyle habits do not show results, medical treatment might be a solution. A physician can prescribe a laxative against obstipation. Sometimes it is possible to recover a damaged sphincter muscle by repairing it with synthetics or creating a new sphincter muscle with dynamic gracilise-synthetics.

In some cases it is not possible to treat fecal incontinence with surgery or medication. Collecting the feces in a stoma may be the preferred option.

Incontinence products for fecal incontinence

In addition to products for urine incontinence, there are products specifically designed for fecal or double incontinence. Abri-San Premium Special from ABENA for instance, is an anatomically shaped pad especially designed for fecal incontinence and double incontinence. Standing leakage barriers with built-in pockets provides extra protect against leakage. Furthermore, the incontinence products prevent unpleasant smells.

In addition to incontinence products, a physician might also sometimes recommend the use of an anal tampon. Anal tampons are only suitable for people who lose bowels frequently during the day and not for overflow diarrhea.