Fecal Incontinence: A Taboo Topic - Legacy Physical Therapy
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Fecal Incontinence: A Taboo Topic

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Fecal incontinence is perhaps the most stigmatized post-reproductive disorder.

It is reported in some form by 20 to 59% of women who give birth – though sometimes not arising until many years after childbirth. Roughly 40,000 women a year will eventually suffer fecal incontinence, but only a fraction of them will ever acknowledge the problem to a physician.

Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Fecal incontinence symptoms range widely. It could be that you have occasional leakage of stool when you pass gas or maybe it’s complete loss of control of the bowel, so you can’t get to the bathroom in time. Maybe it’s just a little bit of smearing on the underwear just by being careful and having really good hygiene practices.

Don’t just think, “We’ll, I’ve never poop my pants. This doesn’t apply to me.”  If you’ve ever had instances where you can’t control your gas or there’s a little bit of smearing on your underwear, that all plays a role in your fecal health.

Range of symptoms:
-inability to avoid passing gas in public
-accidental loss of stool
-soiling of underwear despite careful hygiene

There are some common causes for it. One thing is diarrhea. That is liquidy, watery stool and that is hard for anyone to hold back. On the opposite side, constipation can be a cause. Constipation is when you get a big, firm, hard blockage of stool in our rectum. What can happen is other stool, maybe liquidy stool, can come around the side of it and kind of sneak out and make it hard for us to hold back because our rectum and anus isn’t performing well because it’s full of poop.

Other common causes are muscle or nerve damage, and oftentimes is muscle or nerve damage. Maybe associated with giving birth and having trauma during that time and or as we age. A common thing that can potentially can cause nerve damage is if you’ve been diagnosed with Diabetes Mellitus and have some nerve damage that way may not be able to sense and feel around the anus as well and not able to hold back the urine as well.

Depending on the cause, it may be possible to prevent fecal incontinence.

These actions may help:
1. Reduce constipation. Increase your exercise, eat more high-fiber foods and drink plenty of fluids.

2. Control diarrhea. Treating or eliminating the cause of the diarrhea may help you avoid fecal incontinence. If it’s a prolonged time frame of dealing with diarrhea, you need to be seen by your medical provider and get tested for an intestinal infection.

3. Avoid straining. So many women who are dealing with fecal incontinence have a long history of straining during a bowel movement. Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence. Believe it or not, a lot of adults need some toilet training to figure out how to properly have a bowel movement. Partnering with a therapist can be really helpful in this area.

4. Strengthen Pelvic Floor Muscles. Our Pelvic Floor is the bowl of muscles on the bottom of our Pelvis. They go around our urethra, our vagina and our anus and specifically, around the anus, we have our external Anal sphincter muscle. It’s a little circular muscle and when it contracts, it closes off the anus to make sure bowel movements cannot come out. That muscle, especially if you had a larger tear or episiotomy with the delivery of your children, can get injured. It can have some scar tissue in it and does not necessarily worked as well as it did pre-injury. You may need some training to help get that muscle performing again the way that it should be. Strengthening your Pelvic Floor Muscles, especially your external Anal sphincter muscle, can be very helpful to eliminating Fecal Incontinence.

If you are not sure where those muscles are or how to get them working, you may need to partner up with the Pelvic Physical Therapist to get those identified and set-up a program to get them stronger for you.

Whatever the cause, fecal incontinence can be embarrassing. But don’t shy away from talking to your doctor. Treatments can improve fecal incontinence and your quality of life. If you have Questions about Fecal Incontinence, we are here to help. Reach out to us here at Legacy PT to talk with a qualified pelvic physical therapist about your symptoms.