Faecal Incontinence
It impacts 1 in 4 women after childbirth*1 and remains one of the three big reasons for admission to a residential care facility, along with dementia and decreased mobility.*2
The causes of faecal incontinence include:
- Childbirth where labour during pushing can put pressure on the bowel muscles
- Frequent constipation and straining
- Failure to empty bowels completely
- A prolapse of the rectum, where it ‘drops down’ the the anus
- Inflammatory Bowel Disease
- Fistula or haemorrhoids
- Surgery to the prostate, bowel or rectum
- Certain medical conditions such as Parkinson’s disease, dementia, MS or a stroke which impairs brain signals to the bowel.
- Long standing diabetes can also damage the nerves that help control bowel movements, as can physical disability which can make it difficult to find a toilet in time.
- Women who have HRT may also have a modest increased risk of faecal incontinence
Faecal incontinence may occur during occasional episodes of diarrhoea, however when it happens more often, people may not be able to stop the urge to defaecate.
Symptoms of faecal incontinence include:
- Needing to rush to the toilet to do a poo
- Inability to reach to toilet to pass a bowel movement
- Often accompanied by other bowel issues such as gas and bloating, constipation or diarrhoea.
- Blockage of the bowel due to constipation, resulting in fluid leakage
- Soiling on underwear may or may not be due to faecal incontinence – it can also be caused by prolapsed haemorrhoids or rectal prolapse.
- Depression or anxiety due to the inability to socialise, travel or sometimes even work
If you fail to respond to simple strategies such as adding more fibre to your diet there are more options to help including
- Bowel muscle testing, ultrasound imaging and manometry done on site in our rooms or the public hospital.
- Physiotherapy and bowel retraining
- Minimally invasive procedures such as sacral nerve stimulation. This involves the implantation of a small device in the buttock which sends mild electrical pulses to stimulate bowel nerves. Sacral Nerve stimulation frequently achieves excellent long-term results for many patients and is done in a day procedure setting. Find out more about sacral nerve stimulation here.
- Surgery to rebuild the anus and help prevent any leakage. This may include a rectal sphincter repair for patients where the anal muscles were damaged by obstetric trauma, or simply due to ageing and loss of elasticity. This helps tighten the sphincter so it can close more efficiently.
- Dietary modification which could include moderating triggers such as coffee, alcohol, diary, sweeteners and increasing fibre to thicken stools.
- Other bowel modification medications or techniques.
Sources
Key continence statistics Australia*1
Foecal incontinence after childbirth, the Royal Women’s Hospital Victoria *1
“Don’t suffer in silence!”
Cheryl Clark, 72 , from Western Sydney
“The worst episode for me happened whilst travelling with a friend to Hawaii about six years ago.
The first time it was on the plane, when everything “exploded” and I had to wear a jumper around myself until we landed.
Then again at the airport half an hour later. I had a few episodes of faecal incontinence before but not like this and I was so mortified that I told my girlfriend it was “a bug!”
I continued in this way for three years, not even telling my husband all that time, as I was so embarrassed. I was quite literally living in fear of my bowels every time I left the house. I knew if I could smell something so could everyone else, and the number of times I’ve had to throw out soiled clothes I can’t tell you.
Both my GP and Dr Ellis-Clark really made me feel at ease, which is what we patients need to remember, that there’s not much a doctor hasn’t seen or heard before! Since I had sacral nerve stimulation three years ago, which was a minor day procedure where a bowel pacemaker was implanted things have improved so much. There are still very, very minor episodes but was so much better than what it was and I can leave the house with full confidence.
I think if we can talk about our grandchildren’s dirty nappies we should really be able to talk about our own as well. It’s just part of the human condition. Talking about faecal incontinence is not easy, however if I can help one person do something about and talk to their doctor then it’s worth it!”
Find out more about sacral nerve stimulation here.
Cheryl and her husband Graham, married for 53 years
