Fecal Incontinence

Fecal incontinence is an embarrassing medical problem and socially disabling. Characterized by recurrent uncontrolled passage of stool it is prevalent in upto 15% of the population. Dementia, spinal cord injury, physical disability, diabetes, excess use of laxatives and multiparity are all risk factors. Correct diagnosis is vital. Examination should include the anal wink reflex test to see if there is pudendal nerve damage. Differentiating between urgency, frequency and incontinence is necessary. Endoscopy and other imaging studies may also be warranted to assess other etiologies of loose stool.




Besides the use of adult diapers there are a few simple changes that can be of immense help. Some pharmacotherapeutic agents and some non medication tips are as below.




A regular bowel regimen helps




Maintaining perianal skin hygiene helps decrease irritability.




Biofeedback and perineal retraining exercises have been proven to be helpful.




Use of bulking agents such as high fiber diets, and fiber supplements prevent leakage.




Loperamide helps prevent diarrhea and leakage.




Amitriptyline an older antidepressant can help by preventing frequent bowel movements.




Hyosciamine has been shown to help post meal leakage.




Finally use of diapers, pads, and fecal containment systems for loose stools such as fecal pouches, flexi seal (convatec), etc may be helpful.




Talk to your physician to see if any of the above medications and techniques can help.




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