What is the treatment?

Simple Self Help Measures

• Changes to diet and bowel habit can be helpful for many people. It is worth experimenting with your diet to see if certain foods worsen the situation. In particular, an excessive high fibre diet (too much bran, cereal, fruit etc), too much caffeine or alcohol and a lot of artificial sweeteners can worsen faecal incontinence. 

Drugs may be helpful when

• The bowel is squeezing too strongly (urgency to get to the toilet quickly)

• The stool is very loose

• The sphincter muscles are weak. Drugs can decrease movement in the bowel, make the stool more formed, and make the sphincter muscle tighter. These drugs are well-established, relatively free of side-effects, and safe to use. Occasionally faecal incontinence is due to not emptying the bowel completely, and then use of suppositories or laxatives might be helpful.

Exercise and Biofeedback

Special exercises to strengthen the anal sphincter muscles help many people. Techniques such as biofeedback are now available to re-train the bowel to be more sensitive to the presence of stool, so that the sphincter contracts when necessary.

Surgery

When the sphincter has been injured, leading to a gap in the sphincter muscles, an operation performed through the skin around the anus can improve the problem for many patients. When there is nerve damage to sphincter muscles a different operation to tighten the sphincter will sometimes help.

What else might help?

In the very unusual situation that nothing can be done to decrease incontinence, appliances and advice are available which can make life much more comfortable. Advice should be sought from a local continence advisor; your family doctor can help.

Where should I go for help?

Your family doctor will be able to put you in contact with a specialist who has expert knowledge about faecal incontinence. These problems are common so you need not feel embarrassed about discussing them. Most of the treatments are simple and effective, so do not hesitate to seek advice.

If you would like to talk to a nurse in confidence you can call InContact on 01536 533255 or contact www.incontact.org

The need for research

The causes and treatments for faecal incontinence are still not fully understood and more work is needed to improve treatments and practical help for sufferers.