Bowel incontinence is the accidental or involuntary leakage of faeces (also called stools or poo) or wind. This is commonly caused by constipation, but also may be associated with diarrhoea, and can happen to anyone at any age.
What is the normal frequency for bowel movements?
Normal frequency of emptying the bowel when you are healthy can be anything from three times a day to three times a week. You should have a warning that you need to empty your bowel, but be able to get to the toilet in time without having to hurry.
What causes bowel incontinence?
Incontinence can result from having weakened muscles in the pelvic floor and around the anus. This could be as a result of having chronic constipation or haemorrhoids, or can occur after having children or pelvic surgery, and from some medical illnesses.
Diagnosis
Even though it is quite common, many women are embarrassed to talk to their doctor about bowel incontinence, or are unsure what incontinence is. If you are worried about leakage, try to tell your doctor what’s happening, no matter how trivial you think it is.
Bowel weakness can be diagnosed by:
| Diagnostic approach | What to expect |
|---|---|
| Medical history | Your doctor may ask you questions about:
|
| Physical examination | The physical examination will assess:
|
| Anal manometry | A test of your anal reflexes and sensations where a small balloon-like device is placed in the anus and then inflated. |
| Anal and rectal ultrasound | An ultrasound is used to provide an image of the rectum, the sphincter muscles and surrounding tissue. |
Prevention & management
You can prevent and manage bowel incontinence with a number of simple dietary and lifestyle actions.
| Water | Drink 6-8 cups or glasses of fluid per day. This does not have to be only water, and includes all of your drinks. Not drinking enough fluid makes stools hard, dry and difficult to pass, which increases the strain on the pelvic floor muscles, and can cause leakage around the hard stool. |
| Caffeine and alcohol | Cut down on caffeinated and carbonated drinks and alcohol, as they can contribute to bowel urgency and incontinence. |
| Food | To avoid constipation and strain on the pelvic floor muscles, each day:
|
| Physical activity | Be physically active as this stimulates bowel movement: aim for 30 minutes of moderate physical activity most days of the week, preferably in the morning to get your bowels moving. |
| Pelvic floor exercises | Do pelvic floor exercises regularly to strengthen your muscles. |
| Lifting | Avoid heavy lifting to reduce strain on your pelvic floor. |
| Coughing | Quit smoking as chronic coughing associated with smoking can weaken your pelvic floor – for help call the Quitline on 13 7848 or visit quit.org.au Visit your doctor if you have ongoing respiratory problems that cause you to cough. |
| Toilet habits |
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| Medication | Medication may be prescribed to treat bowel incontinence. |
| Surgery | Surgery may be used to treat some types of bowel incontinence. |
| Continence products | Continence pads come in different sizes and are designed to absorb bladder or bowel leakage. Continence liners are as small as regular panty liners. Ask your doctor, continence nurse, pelvic floor physiotherapist or pharmacist for advice. |
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