Often, simple changes may help reduce bowel incontinence. Your provider may suggest one or more of these treatments.
Diet. Track the foods you eat to see if any types of foods cause problems. Foods that may lead to incontinence in some people include:
- Dairy products (in people who are unable to digest lactose, a sugar found in most dairy products)
- Fatty, fried, or greasy foods
- Spicy foods
- Cured or smoked meats
- Sweeteners such as fructose, mannitol, sorbitol, and xylitol
Fiber. Adding bulk to your diet may thicken loose stool. To increase fiber:
- Eat more whole grains. Aim for 30 grams of fiber a day. Read food labels to see how much fiber is in breads, cereals, and other foods.
- Use products such as Metamucil that have a type of fiber called psyllium, which adds bulk to stools.
Bowel retraining and pelvic floor exercises. These methods can help you control your anal sphincter muscle when you have a bowel movement. Your provider can show you exercises to strengthen the pelvic floor and anal muscles. Bowel retraining involves trying to have a bowel movement at certain times of the day.
Some people can't tell when it's time to have a bowel movement. Sometimes they can't move well enough to safely get to the bathroom on their own. These people need special care. They may become used to not getting to the toilet when it's time to have a bowel movement. To prevent this problem, help them get to the toilet after meals and when they feel the urge. Also, make sure the bathroom is safe and comfortable.
Using special pads or undergarments can help an incontinent person feel safe when they leave home. You can find these products in pharmacies and in many other stores.
If treatment does not work, surgery may help correct the problem. There are several types of procedures. The choice of surgery is based on the cause of the incontinence and the person's general health.
Rectal sphincter repair. This surgery may help people whose anal muscle ring (sphincter) isn't working well due to injury or aging. The anal muscles are reattached to tighten the sphincter and help the anus close more completely.
Gracilis muscle transplant. In people who have lost nerve function in the anal sphincter, gracilis muscle transplants may help. The gracilis muscle is taken from the inner thigh. It is put around the sphincter to help tighten the sphincter muscle.
Artificial bowel sphincter. The artificial sphincter consists of 3 parts: a cuff that fits around the anus, a pressure-regulating balloon, and a pump that inflates the cuff.
During surgery, the artificial sphincter is placed around the rectal sphincter. The cuff stays inflated to maintain continence. You have a bowel movement by deflating the cuff. The cuff will automatically re-inflate in 10 minutes.
Sacral nerve stimulator. A device can be put inside the body to stimulate the nerves that maintain continence.
Fecal diversion. Sometimes, this procedure is performed in people who are not helped by other therapies. The large intestine is attached to an opening in the abdominal wall called a colostomy. Stool passes through this opening to a special bag. You will need to use a colostomy bag to collect stool most of the time.
Injection treatment. This procedure injects a thick gel (Solesta) into the anal sphincter to bulk it up.
If treatment does not get rid of bowel incontinence, you can use special fecal collection devices to contain the stool and protect your skin from breakdown. These devices have a drainable pouch attached to an adhesive wafer. The wafer has a hole cut through the center, which fits over the opening to the anus.