Bowel Leakage, Constipation & Diarrhea

Can’t control your poop? – You don’t need to live this way – we can help!

What happens when you simply cannot wait to get to a restroom and accidentally poop? Fecal or bowel incontinence refers to when you simply do not have the ability to control the urge to have a bowel movement, causing stool (poop) to leak unexpectedly from your rectum. Although it is not apparent, bowel control problems are extremely common; however, many individuals do not want to address this condition with their physician due to the embarrassment. In some cases, patients who have shared this concern with their physician never received the suitable solution for it. Therefore, most individuals simply tolerate the condition unnecessarily with eventually forcing them to constantly be near a restroom and isolating themselves socially. If you suffer from bowel control issues, you know how much they can negatively impact your quality of life. It’s time to speak up and get back to living your life.

Learn the Facts

Nearly 18 million adults in the United States, which is about 1 in 12 adults, have unsatisfactory control of their bowel movements. Despite stool incontinence being more common in adults over the age of 50, it can affect individuals of all ages, although it is slightly more prevalent in women than men. You may be at a higher risk if you have:

• Diarrhea
• Constipation
• Urgency or the sense of having very little time to get to the toilet
• Injury to the nervous system such as stroke or spinal cord injury
• Injury to the pelvic floor, such as trauma from a difficult childbirth
• Muscle or nerve damage associated with age or childbirth
• Poor overall health from chronic conditions such as diabetes and multiple sclerosis
• History of diminished satisfactory control of both bladder and bowel
• Prior anorectal surgery

Fecal incontinence, also known as anal incontinence, bowel incontinence, or accidental bowel leakage; is a loss of control over the ability to properly eliminate stool. This includes a variety of symptoms, often involving the control of gas, liquid stool, mucus, or solid feces. Fecal incontinence is a symptom, not a diagnosis. The inability to detect the need to evacuate can be immensely stressful, often embarrassing, and limiting to social exposure. Effective therapies can make a significant impact, and our practice will tailor treatment to your needs, including offering trusted nerve stimulation therapy.

Why am I leaking poop? – The Known Causes

There are many causes of fecal incontinence that vary among individuals, and many may suffer from a combination of causes, such as:

• Diarrhea or Constipation: These conditions cause the muscles in the rectum and anus to weaken. Chronic constipation, where stool leaks around a large firm stool, can lead to fecal incontinence.
• Muscle Damage: Muscle damage can occur during a difficult vaginal childbirth, for example when doctors use forceps or make a small cut at the vaginal opening. Muscle damage can also result from anal or rectal surgery.
• Age: Muscles in the rectum and anus naturally weaken with age, and other nearby structures in the pelvic area also loosen. Loose stool is more difficult to manage than solid stool. A large amount of loose stool arriving rapidly in the rectum may not allow enough warning to reach the bathroom in time, resulting in accidents.
• Nerve Damage/Malfunction: Bowel leakage can occur if the nerves that regulate the rectum and anus muscles are damaged or if the nerves responsible for the sensation of needing to defecate are damaged. Nerve damage can result from difficult vaginal childbirth, anal surgery, frequent and severe straining during constipation, or certain health conditions such as diabetes, multiple sclerosis, stroke, or a spinal tumor.
• Inability of the Rectum to Stretch: If the muscles of the rectum are not as elastic as they should be, excess stool can leak out. Causes affecting the rectum’s ability to stretch include inflammatory bowel disease (such as Crohn’s disease), scars from surgery, and radiation therapy (which can stiffen the rectal muscles).
• Other Medical Conditions: Certain conditions, such as rectal prolapse (where the rectum falls into the anus), rectocele (where the rectum pushes into the vagina), or neurologic disorders, may affect fecal control.
• Other Causes: Laxative abuse, dietary factors, obstetric injury combined with menopause, perianal fistula, structural anorectal abnormalities, radiation treatments, certain nervous system and congenital (inherited) defects, inflammation (swelling), and inflammatory bowel disease may affect the ability to regulate stool.

What are the symptoms of fecal incontinence?

Symptoms of fecal incontinence can range from mild occasional leakage of a small quantity of stool while passing gas to severe unwanted bowel accidents in public, with the inability to maintain hygiene due to soiling or dirtying your underclothes. Common symptoms include:

• Inability to hold a bowel movement before reaching the toilet
• Inability to control the passing of gas/stools
• Being unaware of having a bowel movement
• Repeated urges to have a bowel movement
• Spotting of feces or complete soiling of underclothes

If there is bleeding with a lack of bowel control, consult your physician as soon as possible. Bleeding may indicate a rectal tumor, rectal prolapse, inflammation within the tissues of the colon and rectum, or conditions such as ulcerative colitis and Crohn’s disease, all of which require prompt evaluation by a physician.

How is fecal incontinence diagnosed?

We will work with you to determine the probable causes of fecal incontinence, beginning with obtaining a complete medical history, which includes asking about your symptoms, bowel habits, diet, medication, and other medical issues. We will examine you to assess the integrity of your muscles and determine if additional radiologic exams are needed to further understand and manage your condition.

Part of the evaluation may include necessary testing such as colonoscopy, radiologic studies, and overall evaluation of medication, dietary intake, and possible dietary causes. Food inflammation testing (FIT) may be considered. We will then tailor your care based on your symptoms and evaluation.

How can fecal incontinence be treated?

It is important to evaluate symptoms with a colon-rectal surgeon before attempting self-treatment. A colon-rectal surgeon will perform a thorough examination and recommend treatment. The physicians at Connecticut Colon & Rectal Surgery, LLC will consider many factors based on your evaluation and develop an individualized treatment plan. Mild symptoms may be managed with a nonsurgical approach, while severe symptoms may require more advanced therapy.

Non-surgical recommendations are tailored per individual and may include dietary modifications, food supplements, evaluation of current management for other digestive disorders, evacuation aids, pelvic floor exercises, and medication regimens to help regain control of bowel function.

For more advanced therapy, our physicians are certified in the latest advancements in fecal incontinence treatment, including sacral nerve neuromodulation with safe and effective MRI-compatible devices. Sacral nerve stimulation improves the ability to detect the urge to eliminate by enhancing communication from the muscles of control to the nervous system. If you are a candidate, we will ask you to undergo a test to determine if this treatment is right for you. Many who qualify after testing often undergo a trial exam first. If you are a candidate, we invite you to say “Yes to the Test.”