Bowel or fecal incontinence and how to manage it

Hello,
Today I had experienced slight bowel incontinence for the first time in my life.

I recently started 4 days ago working out my abdomen and added pre biotics and a certain pro biotic I have taken before. I have had a sleuth of abdominal pain/nausea issues been dealing with (check my former post) and am only in my late 20s.

I had just finished working out a half an hour prior and finished eating a large meal after another large meal last night (as I eat much more when getting physical activity).

My stool/and issues I noted in my prior post have improved dramatically these last 4 days since starting. I am having healthy looking stool again for the first time in years. However I obviously can’t be dealing with what I dealt with today. I definitely have more moisture in my stool, though still formed. However today this extra moisture quite literally slipped out of me.

My questions are, do you think this could be from potentially weakening my anal sphincter muscles post workout as I target my lower core? Or do you think maybe I should cut down on the pre/probiotics to maybe every other day? Or is this something anyone else has dealt with when adjusting to new biotics?

It’s just very strange as I’ve had horrible diarrhea before in my life but never had incontinence.

I suffer from IBS-D and pre-biotics are a definite no-no

I was diagnosed with lymphocytic colitis & I have this problem when I eat sugar or sometimes wheat flour. It’s unnerving.

Hi @jimmoran87

Consider looking at Zoe nutritional. https://zoe.com/
I found it very helpful for overcoming similar issues, although not as extreme as yours that you described in your previous post and this post. I have learned that it takes a very long time to rebuild a healthy gut microbiome. I have learned to stay away from heartburn medications. I cut out all dairy. The problem is what works for me may not work for another. That is what Zoe nutritional focuses on . We are individuals and I think you know that.

Here are my best wishes that you make meaningful progress and have the patience to find a solution that works for you.

What a challenging time you had or perhaps are still having. I used to be able to use probiotics and now cannot. Since you saw the problem so soon after adding the probiotics and prebiotics, it is wise to back off of those. Sometimes those aggravate certain conditions.

My own gut journey has been long and you are young still, so please take the time to make sure you get a proper diagnosis. My own niece is 30 years old and on her own journey. She's busy and lives far away but your story reminds me to reach out to share with her my latest findings in case they can help her. Meanwhile, I'll share with you in case it can help.

Start with your GP if you have not already, but make sure you list any and all of your symptoms before you see them. Your GP likely doesn't have the training or experience to problem solve this; however, they can refer you to a gastroenterologist. At the same time, do not rely solely on the gastroenterologist. They often do not have this kind of training, so rather than wait, start asking everyone in your network if they have a good gastroenterologist they can recommend. If you've already worked with a gastroenterologist, do not give up. Find one more specialized whose training is more current on the latest discoveries for the gut.

Additionally, get yourself a nutritionist that specializes in solving gut issues. Mine actually is the one that noticed I had a histamine intolerance issue going on at the same time as my SIBO (small intestine bacterial overgrowth). Things like SIBO can be tested with a 3-hr breath test but you want the right test -- one that looks at 2 different gases to give your doctor confidence that this is what you have. I'm not saying this is what you have. Just sharing my experience so you'll understand that this can take time to puzzle out. While it is wise to modify your diet to reduce symptoms and find ways to heal your gut -- I do not recommend trying to do this without specialized help. As sometimes your medical team means well but they don't have all the tools/knowledge they need to help you. Whatever you experience, trust that your experiences are real and do not let them just point the finger at stress as the problem. I have found stress aggravates conditions and prevents our bodies from healing so definitely do whatever you can to resolve any problems you have outside of your gut issues; but above all, hold on to hope and persevere to find your answers. I think it's a good sign that you are in the Mayo Clinic blog searching for answers.

In case you find relating to the stories of others helpful, my problems started requiring my attention in my mid 20's when I went back to college for civil engineering. For years I had relied on Diet Cokes to get through my work days (since I didn't drink coffee). Started having GERD like problems during a particularly stressful time in my life, throat specialist recommended a Barium Swallow. Then, a gastroenterologist recommended an endoscopy/colonoscopy; but they found only an acid reflux problem. Prescribed a proton inhibitor. Years later, a memory surfaced of the caution from the gastroenterologist as I was coming out of anesthesia from that endo/colonoscopy -- he had warned me in my groggy state "to be careful because" he was "noticing these types of problems worked there way down a gut system."

Subsequent advice I received years later was that I was "probably" lactaid intolerant. But they only said that after they had already delayed investigating more than structural GI issues again -- meaning after they put me through another endoscopy/colonoscopy. So I took lactaid enzymes when I ate dairy but then the problem did not resolve. Found a new gastroenterologist but while waiting for an appointment, I had to do my own research to figure out what I likely had. Thankfully, he was a God send and listened when I told him it sounded like I had SIBO. Small Intestine Bacterial Overgrowth

If you are still reading -- again, while you wait for an appointment with a knowledgeable gastroenterologist, I would stop taking the pre and probiotics for a while. They do not work for everyone's condition; for instance, those of us struggling with reoccurring Small Intestine Bacterial Overgrowth. I can no longer even eat foods that have moderate to high histamine levels. Unfortunately, we're still in early stages of understanding when pre and probiotics should be recommended. As was said above, every body is individual.

If you continue to have problems, I highly recommend that you do an elimination diet and keep researching. You could try a Chinese Medicine Practitioner, but keep one foot in the traditional medicine field to make sure you aren't overlooking problems. For instance, I learned via a video interview with Dr. Mark Pimental (researcher/gastroenterologist with Cedars Sinai) that he has found SIBO patients even after treatment and supposed recovery from the SIBO that do not do well on probiotics, which makes sense since they are also bacteria and adding more bacteria producing gases (even if we consider them the good bacteria).

Please take your gut health seriously and not only symptomatic. I wish I had when I was your age. Now I break out in hives if I have foods that have a moderate to high histamine level. If you haven't had a SIBO breath test yet, you can have a gastroenterologist order it for you. Sorry this is so long but have to dash to work and I was supposed to be doing a training class this morning instead of this. 😂 I am ADHD amongst all of this. It only got worse with age and my gut issues. Take good care of yourself. Wish you well.

Jim, if you’re experiencing leaking following or during exercise try not to eat large meals before you plan on it. Maybe the quantity of food you’re consuming is causing some of the issue? I commented on your other post too and you need to get yourself healthy sooner than later. By the way how tall are you and is your body weight proportional to your height? I’m not talking BMI.

I am on linzess for about 3 or 4 months now. I was using miralax before and taking double the recommended dose per day. But that was per doctors orders. I was told to take a single dose daily and if I go a day with no poop to take a double dose the next night and if I still do not go to take a triple dose the next night and so on. Finally I was just taking a double dose daily to keep things moving but it was often the firmness of pudding. My big issues is I have Gastroparesis very badly and IBS mostly C. So when my colon stops moving even for a few hours my stomach stops to and often it will take days or even weeks to get everything to calm down and move again. I have a gastric pace maker that helped my Stomach to empty better and I can not say enough good about it. But I was having a lot of accidents day and night so we are trying linezz. I am taking it in the Evening and I am sometimes having accidents at night but overall the urge incontinence i was having got better during the day. I can handle it at night I sleep in a diaper so no big mess and I shower the next morning anyway. So the large urge accidents I was having has slowed. But The minor anal leakage is much much worse with it. I still wear a diaper 24/7 because I do not trust a fart and I have ladder urge and interstitial cystitis going on 30 plus years but all the bowel issues is the last 5 or 6 years since getting the GP disease. So I gave up on pads and pull ups and I wear something I can trust but OMG they are 3 bucks a piece for a diaper. I am to the point I do not give a shit what other think and I came to the conclusion no one cares what type of underwear I have on. But the constant leakage I have now since starting the linezz even on a lower dosage at first it is like a mucus my bowel discharges and it causes inflammation and swelling and burning that flare up the hemorrhoids even more. So My doctor prescribed a new med that works a lot like linzess but different. She told me it has shown to help with gastric emptying to which is what GP is and there are very few meds for GP and none are cheap. So I went to fill it and I guess it makes linzess look like pocket change and my insurance refuses to buy it at $1600 a month. So we are trying to appeal it but it does not look good. The New med is called Motegrity. You might ask your GI about it and maybe your insurance will cover it. She said it has far less negative side effects over linzess. I am on a medicare Advantage plan and my linzess is only $4.15 my cost and I have the best plan Humana has to offer. The Gold Choice plus. I am 47 and had to retire and take my SS-disability because of my joint and gut problems. So I feel for what you are going through. For sure don't give up on living. If you have to wear a quality diaper and just live life. You can take a med that stops the odor if you do have an accident in public. I like the NorthShore diapers best and they do offer free trials if you go to their webpage.

@jvmiller95
Regarding Motegrity- I have bout it online from a Canadian pharmacy. I even decided to try the generic- it works just as well. The price is so much better.
I just started looking at Certified Canadian pharmacies and compared prices.

Hi am in Canada and hadnt heard of Motegrity so will check internet. I have similar symptoms and its a life changer for sure. Mine I think from radiation damage to pelvis was way back in 1985 cancer of cervix stage 2 but hadnt had bowel or bladder problems before.. so its been a long time... starting off with bouts of diarrhea after eating salads, fruit etc. Rushing to bathroom as we all have to do... and just got a bit worse every year and also cutting down on fruit and vegetables and anything "tasty" or spicy is out! Then spouse got anal cancer. Good thing we have two toilets in the house. Mine got worse 2018 after about 6 antibiotics in as many months for UTI's and then got C.Diff... when I didnt think could get worse and was horrible after over 100 pills but thats another story. After CDiff got bowel incontinence and when someone referred to consistency of stools I agree - pudding - which makes clean up so march more difficult. And I also get frequence UTI's no matter how careful I am, shower every morning etc. I can pass up to 10 times and a mess each time, thing is even a small amount is smelly, yucky and as you say, having to change clothing and I have a stack of only for bum facecloths and keep a bowl for them and wash with bleach... because can go through a roll of toilet paper in a day me and spouse! I take Imodium - which is Loperamide - used to pay for but now under prescription so almost no cost but if take a bit too much then only "rabbit pellets" come out - and have pressure - this can happen through night as is said above: I dont wear "diapers" except if say going to hospital for something else or dentist - but truthfully they do not sop up mushy stools and then would be sitting in it. My worry at 80 is ending up in a nursing home setting and no one is going to clean me up at 3am or 6 times a day!! Sympathies to everyone with this! No cure for me.

Oops reading too quickly, thought Montegrity is for diarrhea.... wrong problem, sorry for my confusion. Another day, another shower clean clothing and then what's that odour..... another wash, more clean clothing and washing bedspread as had sat on end of bed - hadnt felt a thing.... no wonder don't go out very often.... been years but still haven't found the magic solution, good luck to everyone for their bowel issues!