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Bowel urgency: Any suggestions?

Posted by lwbarker @lwbarker, Mar 3, 2023

I am 77 and have had bowel urgency for about 12 years. Mostly in the mornings, sometimes loose, sometimes firm, usually two to three BMs. Have had embarrassing incidents of no control when away from home. Recently GI doc recommended fiber supplement, pelvic floor strengthening and Bentyl (dicyclomine) daily. Fiber seems to help consistency. I take Bentyl if going out in the morning. I watch what I eat and drink. Any other suggestions?
Thanks!

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gussie | @gussie | Nov 4 11:18am
In reply to @carolinlv "I have IBS – C and feel like most of the people that take Dicyclomine have..." + (show)
@carolinlv

I have IBS – C and feel like most of the people that take Dicyclomine have IBS – D. Does it work on stomach pain and on spasms for either or does it really target those with diarrhea more than constipation? Thank you for your response. Very helpful!

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I have had IBS-D for over forty years. When the pain starts in my upper GI I take one 20 mg. pill of Bentyl I don't take them on a regular basis. I get side effects from almost everything. Mostly diarrhea but I have found that Bentyl just helps with no side effects. I can't take any PPI they all give me diarrhea. My script is written for one pill every 6 hours for pain.

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msvjv | @msvjv | Nov 5 8:12am
In reply to @astaingegerdm "@lwbarker I have taken Bentyl(Dicyclomine) for decades for IBS, GERD, bile duct problems, autoimmune colitis and..." + (show)
@astaingegerdm

@lwbarker
I have taken Bentyl(Dicyclomine) for decades for IBS, GERD, bile duct problems, autoimmune colitis and celiac artery stenosis. Definitely my go to drug.
It is anticholinergic and I get dry mouth.
I think you got good recommendations- pelvic floor strengthening is very important in helping you hold it in until you reach a toilet.
On and off I also have same problem, mostly if I have a recurrence of the colitis.
Therefore, I always have to know where the toilets are when I’m out. I also often wear an incontinence pad.
You can also try taking Imodium before leaving home.

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Hi. Is there an actual pad for bowel incontinence or is it a brief you use?

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Ingegerd Enscoe, Alumni Mentor | @astaingegerdm | Nov 5 12:23pm

@msvjv
I would use either an incontinence pad or menstrual pad.

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slkanowitz | @slkanowitz | Nov 7 6:16am

If stools are loose, have you tried just taking 1/2-1 Immodium tablet before going out? It works really well to stop movement in the GI tract but you don’t want to use it every day or it will make you constipated. Try it first before you go out and then experiment with it, keeping up with the fiber to keep stool consistency soft and stable.

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p95 | @p95 | Nov 8 12:56pm

I've tried it all - psychotherapy, functional medicine, fiber, Imodium, pelvic floor training, biofeedback, bowel training, balloon therapy - you name it. Finally, Pelvic Floor Rehab suggested I have a consult with my urogynecologist about Axionics (a sacral nerve stimulator) for bladder or bowel accidents. I'm currently undergoing the Stage 1 Trial (done in my urogynecologist's office. The stage 1 trial is temporary and lasts for 1 week. Leads are placed near the sacral nerve and connected to an external stimulator. It provides continuous stimulation to the nerves that communicate between the brain and the bowel. If I pass the trial (which means I have to have a 50% improvement in the number and urgency of BMs), I will move on to Stage 2 (permanent implant done in the hospital as outpatient surgery). My urogynecologist has an overall 92% success rate with it. 85% success rate for bowel control. My urogynecologist has done over 100 of these procedures over the past 5 years. Look it up - sacral nerve stimulator. There are YouTube videos and Facebook Groups on it too. It's something to consider if you've tried everything else. I'm really surprised there is nothing here on this site discussing it.

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