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April 2006 Issue

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Incontinence Embarrassing, but Treatable

By Amanda Harper
Published April 2006

UC colorectal health experts say that millions of people live with the partial or complete loss of bowel movement control because they are too embarrassed to seek help.

There is a stigma associated with incontinence, so many people never mention it to their doctors or seek treatment,” explains Bradley Davis,MD, a colorectal surgeon at UC.

“In reality, fecal incontinence is a very common and often very treatable condition.“ First,” adds Dr. Davis, “you have to admit there’s a problem and seek help.”

Fecal incontinence is the inability to control voluntary bowel movements. The loss of control can occur partially—when a small amount of liquid escapes—or completely, when control of solid bowel movements is lost.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, more than 5.5 million Americans live with fecal or bowel incontinence. Although the condition can affect people of all ages—including children—it is most common in adultsover age 55, particularly women who have given birth to multiplechildren.

Fecal incontinence can be caused by a variety of factors, including sphincter muscle and nerve damage, chronic constipation, previous anal surgery and other disorders that cause weakness in the pelvic floor. The condition has also been linked to bad toileting habits—such as straining and pushing to have a bowel movement—and poor dietary choices.

Treatment usually involves a combination of lifestyle changes, medications and muscle-strengthening pelvic exercises,says Dr. Davis.

Often incontinence can be managed with dietary changes, which will also improve your overall colorectal health. He suggests the following tips to help manage fecal incontinence through your diet:

  • Track problem foods. Keep a log of what you eat and look for correlations between the foods you consume and your bowel health. Identify the foods that result in problems and cut back on them. Common diarrhea inducing foods include spicy or fatty foods, cured or smoked meat and dairy products.
  • Manage your fiber intake. Both consuming too much and too little fiber can contribute to incontinence. You need about 20 to 30 grams of fiber daily, but your body needs time to adjust. Gradually add more high-fiber foods—such as vegetables, fruits and grains—to your diet. This will create bulky and more easilypassable stools.
  • Drink plenty of fluids during the day. Constipation is caused by dehydration, so to keep stool passable you should drink 64 ounces of water a day to keep food moving through the digestive system. You should avoid alcoholic or caffeinated beverages, which can cause the internal sphincter muscles to relax and contribute to incontinence. Severe incontinence cases may require surgery to repair the damaged areas or replace the sphincter muscle. In most cases, however, Dr. Davis says incontinence can be improved—and even cured.

“The important thing is that you address the problem,” says Dr. Davis. “Incontinence is socially embarrassing, but there’s absolutely no reason to let it control your life.” 

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