Fecal Incontinence

Care & Treatment

Depending on what is causing or contributing to fecal incontinence, your healthcare provider may recommend one or more of the following:

  • changes in diet
  • medications
  • pelvic floor muscle exercises
  • “bowel training” 
  • surgery
  • other therapies
  • a combination of the above

Diet

Both constipation and diarrhea can contribute to fecal incontinence. If you have constipation, adding high-fiber foods to your diet and drinking enough water and other clear liquids (eight or more 8-ounce glasses daily) can make your stools softer and easier to pass. Whole grains, fruits, vegetables, dried beans, and other legumes are all good sources of fiber. Ask your healthcare provider whether you should also take fiber supplements. Be sure to increase the amount of fiber in your diet gradually. If you overdo it, you may develop diarrhea. Caffeine, which can also contribute to diarrhea and fecal incontinence, should be limited by cutting back on items such as cola drinks, coffee, tea, cocoa, and chocolate. Many sugar-free diet drinks, foods, and chewable medications contain artificial sweeteners, such as sorbitol, that can cause chronic diarrhea.

Medication

If necessary, your healthcare provider may prescribe medications or recommend over-the-counter medications. These can include medications like a “bulking agent” (such as methylcellulose) to make stools bulkier and less watery. If you have diarrhea and it continues even after you make changes to your diet, your healthcare provider may prescribe an anti-diarrheal medication such as loperamide (Imodium).  Some prescription and over-the-counter medications may cause diarrhea or constipation as a side effect, and your healthcare provider should check your regular medications for these potential problems. If you decide to take these over-the-counter medications, it is very important that you follow the package directions, and not to “double up” or even “triple up” on the usual recommended dose. Doing so may cause serious harm to you.

Exercises and Biofeedback

Exercises that strengthen your pelvic floor muscles may improve your ability to control your bowels. Your healthcare provider can show you how to do these exercises.  Your provider may refer you to pelvic floor rehabilitation therapy, where a specially-trained physical therapist will perform an evaluation and recommend an exercise plan.  Your provider or physical therapist may recommend biofeedback, which is a technique for training your body by closely focusing on information it provides. This will help to make sure you’re doing the exercises properly. Biofeedback can help re-train pelvic floor and nearby muscles.

Bowel Training

Bowel training can be particularly helpful if cognitive problems or physical disabilities are contributing to fecal incontinence. Training involves trying to have a bowel movement at scheduled times of each day—for example, after every meal. It can improve constipation by getting the body in the habit of having regular bowel movements. 

Surgery

When fecal incontinence is due to damage to the sphincters or to the pelvic floor, your healthcare provider may recommend surgery. One type of surgery, called sphincteroplasty, can repair damage to rectal sphincters due to childbirth or other injuries. Another type of surgery involves implanting an inflatable cuff, called an artificial sphincter, at the end of the rectum.

 

Last Updated July 2020