Managing Bowel Incontinence with Courage and Dignity
Having incontinence means that you have diminished or no control over your bladder, bowel, or both. Incontinence comes in several stages, which vary according to a person’s age, medical condition, gender, and disability.
While urinary incontinence is more common, and comes naturally to most people with age, fecal incontinence (also called "bowel incontinence") is always symptomatic of a larger problem. If you or a loved one are experiencing fecal incontinence, you need to see a medical professional about the cause as soon as you are able.
This is often a difficult thing to seek treatment for, as people are often too embarrassed to ask for help. But with courage and patience, you will be able to address the problem and maintain your dignity.
Fecal incontinence is not that common. Medical studies show that only 1 to 10 percent of the world’s population experience this medical symptom. While this is good for most of us, it adds another layer of shame and stigma to the person suffering.
There are a few more reasons why, if you are experiencing fecal incontinence, you should consult a doctor right away:
- Bowel habits are extremely personal and can affect multiple aspects of a person’s daily routine, so quality of life is nearly always affected when someone has a symptom like this.
- Fecal incontinence rarely (women after childbirth are an example) resolves itself without medical intervention.
- The cause of your fecal incontinence is something you won’t be able to diagnose yourself. One factor or multiple factors may be at fault.
- You won’t know what the future holds, until you’ve been evaluated by a professional. Do not assume that fecal incontinence is “the new normal,” or that it will always be this way from here on.
Who is most at risk for fecal incontinence?
Fecal incontinence and urinary incontinence are symptoms. As such, they are not diagnoses or conditions, but bodily responses to a problem. Some people will have incontinence issues simply because their body is not as muscularly strong as it once was. Some people will have incontinence as a result of trauma or injury. Some people will have one or both types of incontinence because of a neurological condition that stems from birth or from an accident.
While fecal incontinence is not common, there are sets of people who have a higher risk of experiencing it at some point in their lives, including:
- the elderly,
- those with regular diarrhea,
- women after childbirth (but usually only for a short amount of time),
- women after childbirth who have had severe vaginal or perineal tears,
- people with spinal cord injuries or disease,
- people with cognitive impairment or the inability to “potty train,”
- people who already experience urinary incontinence due to lack of muscle tone,
- people who have had bowel surgery,
- people who have had digestive tract or reproductive organ cancers,
- people with severe constipation, and
- people with enlarged colons or rectums.
Just because you fall into one of these categories does not mean you will ever have fecal or urinary incontinence. It’s not guaranteed. It just means you’re more likely than someone who does not have any of these medical conditions.
Doctors and caregivers should be sensitive to embarrasment over bowel incontinence.
If you are a medical professional, sparing your patient the news that they have fecal incontinence — and may suffer from it again — is not an option. You can, however, spare their emotions by understanding that this symptom is a private matter. It is embarrassing. It disrupts and disturbs their daily life. It is troublesome to say the least. Keep in mind that your patients need reassurance about treatment and to know the incontinence products available to them. They need information about diet, skin care, hygiene, and Kegel exercises. They need to be respected and listened to.
If your patient has suffered from incontinence for a long time, they may know tips and treatments you can pass on to other patients (excluding names, of course, to prevent violating HIPAA). Informed patients and uninformed patients all have the right, though, to make decisions about their care. Working with your patient will yield better outcomes and less headaches.
Since there are many different types of people who suffer from fecal incontinence, there are many different beliefs, religions, and cultural practices among the people who suffer. All treatment methods must be appropriate for the specific patient. You must inform the patient in a manner they understand. Your information about the symptom, treatment, and self-care must be accessible for people with different levels of ability.
You do not want to leave the understanding or treatment of fecal incontinence up to chance. Feces is detrimental to the skin and can cause irritation and debridement that leads to infection. These infections can become life-threatening if not cared for. Do not risk your patient’s health because you can’t understand them or they can’t understand you. Seek other ways of communicating.
Fecal incontinence diagnosis and treatment. What should a patient expect?
If you are the one suffering from fecal incontinence, you don’t have to feel ashamed. Fecal incontinence is not something that you can control. It is a physiological response of the body when the bowel and rectum are not working properly. For this reason alone, if you suffer from fecal incontinence, you must see a doctor about it.
Know that fecal incontinence will not usually fix itself, and it is a symptom of a larger problem. If you feel embarrassed about it, explain to the intake nurse that you have an embarrassing situation involving your bowel habits. That way you don’t have to explain yourself too many times before you see the actual doctor. When you do see the doctor, you must explain yourself clearly, though. Even if you have to write it down on a sheet of paper and have the doctor read it, the doctor needs to know exactly what the problem is.
When you see the doctor, they will take a baseline medical history. You will need to explain your medicines, vitamins, supplements, diet and lifestyle (including any illegal drugs or alcohol consumption), exercise regimens, stress, sleep patterns, and changes to your way of life. You will need to explain when the fecal incontinence occurs, how often, what time of day, and any other information relating to the incontinence episodes.
Your doctor will want to conduct an exam of your body that may include a rectal exam. Know that this is a way to diagnose whether or not the cause of your incontinence is a purely physical issue. Your doctor may also want to conduct a cognitive test of your brain function. This is a way to test your nervous system, to make sure the problem isn’t stemming from a neurological disorder.
Based on your medical history and exams, your doctor may require further tests of your digestive tract. He will want to speak with you about healthy stool consistency and frequency. If there are any physical or mental rehabilitation services required, he will recommend them.
Examples of rehabilitation include pelvic floor exercises (also known as Kegels), bowel retraining, “potty training” for children or the mentally impaired, diet and nutrition counseling, electrical stimulation of the muscles in the colon, and enemas or rectal irrigation in cases of enlarged colons from severe constipation. The doctor and rehabilitation specialist will know which treatments are appropriate for which patient.
Taking care of our bodies means more than taking care of what we put into them. It also means taking care of what comes out. While no one wants to talk about their bathroom habits, a problem of urinary or fecal incontinence is nothing to be ignored. These problems will not treat themselves and, if left untreated or undiagnosed, can lead a person to more and more health and dignity issues. How we use the bathroom is a matter of immense privacy for most individuals. If your bathroom habits change, you will know it, and if they do, a call to the doctor should be one of the first steps you take.
SuLauren Wilson is the founder of Finnegan Medical Supply, an online medical supply store based in Little Rock, Ark. She blogs regularly on issues affecting the company’s patients. Although, she has many years of experience in the healthcare industry, she is not a licensed medical professional, and the content of her posts should not be considered medical advice.