What Is Accidental Bowel Leakage?

A Gynecology Specialists note: Following is an excellent article by the American College of Obstetricians and Gynecologists. Since 2004, our GYN doctors have treated women with bowel leakage. If you have any questions or would like to schedule an appointment, please contact our GYN Clinic at (757) 312-8221.

What is accidental bowel leakage?

Accidental bowel leakage is loss of normal control of your bowels. It also is called fecal incontinence. This condition leads to leakage of solid or liquid stool (feces) or gas.

Why does accidental bowel leakage occur?

Accidental bowel leakage can occur if there are problems with the muscles and nerves in the rectum and pelvis. The large intestine (also called the colon) must be able to form and store the stool until you can get to the bathroom. The following problems can lead to accidental bowel leakage:

• Injury to the sphincter muscles of the anus
• Loss of feeling in your rectum
• Inability of your rectum to stretch and store stool
• Stool that is too liquid or loose
• Severe constipation

What are some of the causes?

The most common cause of accidental bowel leakage is childbirth. During childbirth, the muscles and tissues of the rectum may be stretched or torn or your anal sphincter can be injured. Other conditions that can lead to accidental bowel leakage include:

• Hemorrhoids that have prolapsed (protrude from the anal opening)
• Certain medications that cause loose stools
• Certain illnesses, such as diabetes, multiple sclerosis, or stroke, that can damage the nerves to the rectum and cause loss of feeling
• Problems with the gastrointestinal system, such as inflammatory bowel disease, irritable bowel syndrome, or cancer of the rectum
• Surgery or radiation therapy to the pelvic area

What are the symptoms?

Women with a bowel control problem may leak gas or liquid or solid stool. Other symptoms may include a strong or urgent need to have a bowel movement, stool spotting on underwear or pads, diarrhea, and constipation.

How is the cause diagnosed?

Your Gyn doctor first will ask about your medical history and symptoms. You likely will have a physical examination of your vagina, anus, and rectum to look for signs of problems, such as loss of normal nerve reflexes or muscle tone. In some cases, tests may be needed, including anoscopy or proctoscopy (a short scope to see inside your anal canal or rectum), anorectal manometry (checks the strength of your anal sphincter), defecography (an X-ray test of your rectum and anal canal during a bowel movement), nerve tests, and an ultrasound exam.

How is accidental bowel leakage treated?

There are several ways that accidental bowel leakage can be treated. The type of treatment that you have depends on the cause of the problem and how severe it is. You may be referred to other health care providers who specialize in treating accidental bowel leakage. Treatment can include lifestyle changes, biofeedback, medications, sacral nerve stimulation, injections, and surgery.

What types of lifestyle changes can help?

Having regular bowel movements can be helpful in preventing constipation and diarrhea and treating accidental bowel leakage. If you have constipation, your Gyn doctor may suggest more exercise. If you are taking a medication that has diarrhea or constipation as a side effect, your Gyn doctor may change your dosage or switch you to another medication. Bowel retraining — training yourself to have regular bowel movements at the same time each day — may be recommended. Dietary changes also may be helpful.

What dietary changes are helpful?

Certain foods can cause diarrhea. Dairy products and foods that contain gluten can cause gas and diarrhea in some people. Some artificial sweeteners can cause diarrhea. Some people have trouble absorbing fatty foods. Spicy foods can irritate the stomach lining, as can alcohol and caffeine. Keeping a food diary can help you identify the foods that cause your symptoms.

If you have constipation, your Gyn doctor may suggest eating more fruits and vegetables, drinking plenty of water, and adding fiber. You should eat about 25 grams of fiber daily. Foods that are high in fiber include bran, beans, berries, and green, leafy vegetables. You also can add fiber by using fiber supplements.

What exercises can help?

Kegel exercises strengthen the muscles that surround the openings of the anus, urethra, and vagina and may improve accidental bowel leakage. If you have trouble locating the right muscles, biofeedback training may be helpful. In biofeedback, sensors are placed inside or outside the anus that measure the strength of the muscle contraction, shown on a monitor, so you know you are contracting the right muscles and how strong the contraction is.

What other treatments are available?

Your Gyn doctor can choose a medication that fits your individual situation — medications that treat diarrhea, control gas leakage, or prevent constipation can be prescribed. Sacral nerve stimulation can be used when the nerves that control the bowels are not working correctly. In this treatment, a device is implanted under the skin, usually right above the buttocks, and sends a mild electrical signal to the sacral nerves, which control the colon, rectum, and anal sphincter, restoring the normal function of the bowels.

If you are suffering from bowel leakage and have questions, please contact our GYN Clinic at (757) 312-8221.