Bowel incontinence, or ‘faecal incontinence’, is a problem with the control of bowel movements. In some people it can be a problem with controlling the passage of wind, whilst others might experience loss of control of (loose) stools.
IS THIS AN UNUSUAL PROBLEM?
No, it is in fact very common. Around 10-15% of people in the United Kingdom have some sort of problem with faecal incontinence.
There are many causes of incontinence. Three of the most common are:
- Problems of the muscles of the pelvic floor or anal sphincters
- Problems of the nerves of the pelvic floor or anal sphincters
- Bowel prolapse
These problems may be the result of damage caused by difficult childbirth, prolonged straining, surgery, smoking or just natural aging. Often it is a combination of factors and may not come to light until many years after injury as the muscles weaken with ageing.
We recognise different patterns of incontinence. Some people suffer from leakage of stool from the anal canal without them being aware that it is happening (passive incontinence). Other people know that they need to open their bowels but cannot get to the toilet in time (urge incontinence). Others notice leakage after opening of their bowels (post-defaecatory leakage). Often these problems occur together.
WHAT TESTS DO I NEED?
When you are seen in clinic the consultant will take a full history and carry out a clinical examination. Usually this will involve a rectal examination, where a gloved finger is inserted into the anus to check for problems and a rigid sigmoidoscopy.
Anorectal physiology and endoanal ultrasound examine the structure and function of the muscles and nerves. If there is a suspicion that bowel prolapse may be causing the symptoms, then we may suggest a defaecating proctogram and transit study .
IS THERE ANY TREATMENT?
Almost all people with incontinence can be helped and a significant proportion can be cured. There are many treatments, depending both on the severity of your symptoms and the outcomes of your tests.
- Simple dietary changes can improve symptoms dramatically. Advice and help with planning such changes can be given by our nurses, or by a dietitian.
- Pelvic floor retraining can improve symptoms dramatically.
- Percutaneous tibial nerve stimulation, a relatively non-invasive treatment which can help control in some patients.
- Sacral nerve stimulation is a relatively new treatment therapy where a pacemaker is used to assist your bowel function.
- Surgery may help. The exact procedure we recommend will depend on your symptoms and the results of your investigations.
For further information you could visit: https://www.bladderandbowelfoundation.org
On the website https://crm.disabilityrightsuk.org/radar-nks-key you can find information on how to obtain a special key that guarantees you independent and rapid access to locked public toilets around the country.
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Please be advised that the information on this website is not a substitute for professional medical advice, diagnosis or treatment