Bowel incontinence

Hi @emyliander,

I’m tagging @oakbourne @astaingegerdm @cmdavis88 @sue225 @jjren @beanglow @sjmoore @jodielynn @susan2018 @missmia @guthealth as they’ve talked about microscopic colitis and/or celiac disease; I’m certain they will return to share their insights with you.

Accidental bowel leakage (or fecal incontinence) can also occur if there are problems with the muscles and nerves in the rectum and pelvis. Have you consulted a gastroenterologist about this?

Hi @kanaazperei, yes I have been under the care of a Gastroenterologist for a number of yrs, he has only told me to take Peptobismal

Have you had any testing for Pelvic Floor dysfunction? Or has your doctor suggested physical therapy for this problem? If not, I’d suggest you pursue these options.

None have been suggested, I will follow up on this. Thank you for the suggestion. Before I joined, I didn’t know anything about Urogynecology. I am traveling to Spain in August and hate to think of having to deal with this.

@emyliander - I know too well what you are talking about. I also have microscopic colitis and IBS. However, I also had damage to the anal muscle at childbirth. I totally agree that you should be evaluated for pelvic floor dysfunction. PT for this is very helpful.
Another common cause of leakage is chronic constipation. The large intestine would be packed with stool and looser stool would slide down around it- out of your control. With IBS there often is a motility problem. You could have soft or hard stool with constipation. There are many ways to deal with this: fiber like Citrucel daily, laxative or enemas. Your gastroenterologist should be able to help you.
If I’m afraid of leakage I also wear an incontinence pad. Not fun!

Thank you, @astaingegerdm . Even though you had muscle damage, were you able to be helped by Urogynecologist. Have you tried PT ? I too wear a pad, I am not even aware when the incontinence happens, so until I go to the bathroom I’m unaware of it and worry about odors. Then theres the major cleanup with wet wipes that can’t be flushed even if they say they can. Apparently they still clog pipes. At night I wear adult disposable pants,
Thank you again for your input.

@emyliander Hi Emy. I see you have been on Connect for a while but this is the first time that I remember having a common interest, so I am glad to meet you through the thread that you started, although not thrilled with the problem we have in common.

I too have fecal incontinence. I went to a urogynecologist for urinary incontinence and they also deal with fecal incontinence. She sent me for pelvic floor PT which did help a bit. She also sent me to a gastroenterologist for an anorectal manometry, and my muscles are very weak. Apparently, that goes back to when my son was born, and I tore right through my anal sphincter. My son is now 38 but that was not a problem until recently, so that does seem a bit odd to me. It started being a problem after having to take immunosuppressants which caused my stools to be soft and unformed -- they classify very soft stools as diarrhea. After a very long time of trying to figure things out, I came to realize that my stool problem was primarily lactose intolerance, apparently triggered by the immunosuppressants. I do occasionally have a fecal incontinence problem even with small, formed stools though. Eliminating dairy has helped substantially.

There is little they can do for this. There is a surgical procedure but it does not have the best success rate from what I have been told. There is another procedure where they insert some type of mesh to hold the muscles up. That is supposed to have a high success rate. If you are interested I will try to find more info on it. I live in southern NH and use Boston hospitals, generally Mass General, but the only doctor who does this is at Mount Auburn Hospital in Cambridge. I have held off for now simply because I have a limit on how many doctors and medical things I can endure, and as I said above, eliminating dairy has helped somewhat. I also do not like going to the bathroom and finding a surprise on my pad. My husband reassures me that he never detects any odor though.

Here is more info from the Mayo site:
https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/diagnosis-treatment/drc-20351403
JK

Thank you JK, you’ve given me a lot of information, I looked up the https info, very interesting. I do not eat meat but eat fish, and about 4months ago I gave up dairy also, I use Almond milk, and non dairy butter. I’ve also cut back on sugar. I drink green tea which does have caffeine, so I’ll try to find a non caffeinated one. Along with my Celiac diet it can be quite challenging. I’m going to check with my insurance to see if I need a referral for a urogynecologist, if I do I’ll get one. Nothing ventured, nothing gained. , I’m trying to remember to do the Kegel exercises. I plan to walk more, was out walking this morning. I need to increase my fluid intake with

@emyliander Finding a urogynecologist can be a challenge. It's a relatively new specialty. I found one here in NH and she is supposed to be good, but the wait for an appointment was at least six months. I ended up going to Mass General for that too, that department there has three urogynecologists.
When I went to the physical therapist, primarily for UI, she said to not skip more than two days, it really sets you back. We went to NYC over the weekend to visit my daughter and I skipped at least 3 days with the getting ready to go and the settling in when we returned, maybe 4 days. I really did see a huge difference this week.
I am supposed to drink 80 - 100 ounces of non-caffeinated beverages a day to keep my kidneys happy so between that consumption and urinary incontinence I really go a lot, particularly at nighttime. I get up at least five times during the night. As morning approaches and I am sleeping less soundly, I am up every hour, but that, of course, is for UI, not fecal incontinence.
JK

Hello @emyliander

I have been following this discussion for a couple of days and feel that it is time for me to weigh in as well. I understand about this unexpected leakage. Having had several surgeries of the digestive tract and also a neurological disorder provides ample reasons to contend with this type of problem. I found what Kanaaz said interesting in that it can be related to problems with muscles and nerves in the rectum and pelvis. I have problems with incontinence especially when I'm physically tired. It seems that the muscles lose their strength. Do you find this true as well?

I'm glad that you are going to try and see a urogynecologist. I hope that gives you some help. At Mayo Connect, we all learn from each other. I hope you will post and provide updates as you search for answers. I look forward to hearing from you again.