@dnikulas I have not had your problem, but because of having gallbladder out and stomach surgeries I sometimes have dumping syndrome. You have probably read this article or others like it: https://www.mayoclinic.org/diseases-conditions/fecal-incontinence/symptoms-causes/syc-20351397

I would keep a food diary to see if any foods contribute to your problem. Diet with me has helped a lot for the urgency of loose bowels. Another thing that helped me is taking a probiotic. I tried several, but the only one that helped me is Align. Instead of a daily problem it is now once or twice a month.

I would also get a second or even a third opinion of what is causing your problem.

Best of luck,
Zaroga

@dnikulas I have fecal incontinence also. Thankfully, I did not pass large amounts of stool with no warning, but I did pass small amounts without knowing until I went to the bathroom and discovered some stool on my pad. I had an anorectal manometry which confirmed my muscle problem. When my son was born I tore through my anal sphincter and they tell me that has contributed to my problem. After having a large bowel movement I would continue to leak for a while and that was a real problem. It was discovered that I have a rectocele (sort of a hernia) that apparently catches some of the stool and then it slowly discharges after having a bowel movement. There is surgery to correct rectocele and also surgery to tighten the anal muscle but I have been told the success rate is not great so I opted to not go that route. There is one other treatment that involves an anal sling for fecal incontinence that holds the muscle up so that it does discharge when you are not prepared. If you google " anal sling" there are a number of articles about it. I am considering it but so far giving up dairy and the PT has helped enough that I have chosen to not have any surgery.

I have been to pelvic floor PT for urinary incontinence and that included PT for the anal muscles, and has helped. I also became aware that my soft stools that were leaking out were a result of my being lactose intolerant. It took me quite a while to pinpoint that but since I have given up eating anything with lactose it has helped tremendously.
JK

This is a terrible problem for you. Did the GI who recommended Metamucil and suggested that you have IBS explain the dietary connections and refer you to a nutritionist? Have you had testing to rule out conditions like celiac? Have you had a colonoscopy? I had a similar problem with “the urges” and do have IBS. The low Fodmap diet is terrible but has mostly solved the bathroom emergencies. I can’t imagine all of that Metamucil.

I know this is an old post, but if you are still suffering, may I suggest you look into Axonics for sacral nerve stimulation. It has been shown to help with both bladder and bowel incontinence. I only have bowel incontinence probably from nerve damage from the birth of my only child which was 36 years ago, but my problem has been getting steadily as I have aged. I'm 70 years old now and have been struggling with bowel incontinence for many years. My daughter weighed in at 8 lbs. 7-1/2 ozs. and they had to use forceps to get her out plus I have a very small frame. My urogynocologist performs this procedure. I'm not sure what other specialties do it. It does require a trial phase where leads are place in the sacral nerve and all the wires and battery are taped to your backside. If you pass the 1-week trail with a 50% or better improvement in urgency and number of bowel movements, you go on to phase 2 which is surgical implantation of the device/wires. I tried everything from keeping a food diary, to low FODMAPs, to increasing my fiber, to Pelvic Floor Rehab, to daily Imodium (which helps, but causes a rebound effect for me). I am only 2 weeks post op from having the implant and have seen a dramatic change in urgency and number of bowel movements. I wish you the best of luck.

Fecal Incontinence ?
RX Colesevlam 625mg t.i.d (3x) & Dicyclomine 20mg b.i.d (2x) per day. This brought me from Chronic Diarrhea to Constipation in 2 months. Make sure dr has your full attention & Listens. I return to dr 12/12/23 w/o going 3 days. Dunno whether to kiss z doc or be alarmed? Not addressed at all. doc had an intern w him & was Obviously Preoccupied. STOP if you Stop going 3 days.