Incontinence: An Overview

Treating Fecal Incontinence

Treatment of Fecal Incontinence

Several methods are available for treatment of fecal incontinence.^[15] They include medicines, various therapies and surgery.

Medicine

Surprisingly, a number of familiar over-the-counter remedies may be used to treat fecal incontinence. Before using these, you should be sure to talk to your doctor about which treatment is best for you. He or she may also suggest a prescription medicine. Medicines that can be used for fecal incontinence are:^[15]

• Anti-diarrheal drugs. These drugs can help stop diarrhea. One of them is loperamide (Imodium).

• Laxatives. If chronic constipation has caused your incontinence, your doctor may suggest temporary use of a laxative such as milk of magnesia.

• Stool softeners. These products reduce hardening of the stool.

• Other medications. If diarrhea is a problem, your doctor may recommend drugs that reduce the contractions of the bowel or drugs that decrease the water content of your stool.

Therapies

There are various types of therapies that can help with fecal incontinence.^[15] These are treatments that do not involve medication or surgery. Such therapies may include the following:

• Dietary changes. Diet changes such as increasing the amount of fluid you drink or increasing the fiber in your diet may be useful. Your doctor may suggest that you stop drinking alcohol or caffeinated drinks.^[19] Dairy food may be another source of trouble. Some people may experience problems with nutmeg and sorbitol. Foods that maybe helpful by increasing bulk include rice, bananas, whole wheat, bran, yogurt and cheese. Be sure that the dairy products don't become a problem. This can happen if you are lactose intolerant. You may want to use over-the-counter products such as Metamucil.

• Bowel training. This involves increasing the strength of the muscles that control defecation or bowel movements. It may involve learning to go to the bathroom at specific times of the day such as after eating. Biofeedback may be used to help you learn how to control the muscles for bowel movements.

• Treatment for hardening of the stool. Your doctor may physically break up hardened stool using one or two fingers.

• Sacral nerve stimulation. The sacral nerve controls bowel movements. Electrical stimulation of this nerve can help some people who have incontinence due to nerve damage. If this method is successful, you may have a permanent stimulator implanted.

Surgery

In some cases, it may be necessary to use surgery to resolve fecal incontinence.^[15] Surgery can have complications and your doctor will discuss this possibility with you. Surgery can be helpful for people who have incontinence due to childbirth or a physical distortion of the rectum (rectal prolapse). Surgical methods include:

• Sphincteroplasty. This surgery repairs damaged or weakened muscle in the anus.

• Treatment of rectal prolapse or hemorrhoids. Distortions of the rectum can be repaired with surgery.

• Sphincter replacement. An artificial anal sphincter (the muscle that controls the anus) can be used to replace a damaged sphincter. This involves inserting an inflatable cuff that is controlled with a small, external pump.

• Colostomy. This method is used as a last resort. This involves connecting the colon to the wall of the abdomen. Stool is directed into an external bag.

This Elder Health Guide was published on October 13, 2009 and was updated on October 15, 2009.