Fecal Incontinence: Care Instructions

Overview

Fecal incontinence is the loss of normal control of your bowels. You may not be able to reach the toilet in time for a bowel movement, or stool may leak from your anus. Fecal incontinence can be caused by constipation, diarrhea, or anxiety or other emotional stress. It can also result from nerve injury, muscle damage (especially from childbirth), lack of exercise, or poor diet.

Treatment of fecal incontinence depends on what caused it and how bad it is. It may include changes to your diet, medicine, bowel training, or surgery. More than one treatment may be needed.

Loss of bowel control can be hard to deal with. You may feel ashamed or embarrassed, and you may not want to leave the house because you fear that you might have an accident in public. But treatment can help you better control your bowels and manage your incontinence.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Keep a food diary of what you eat. This will help you learn which foods make your incontinence worse.
• Eat small, frequent meals. Large meals may cause diarrhea.
• Avoid constipation:
  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
  • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
• Try pelvic floor (Kegel) exercises, which tighten and strengthen the pelvic muscles. (If doing these exercises causes pain, stop doing them and talk with your doctor.) To do Kegel exercises:
  • Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine. Your belly, legs, and buttocks shouldn't move.
  • Hold the squeeze for 3 seconds, then relax for 5 to 10 seconds.
  • Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.
  • Repeat the exercise 10 times a session. Do 3 to 8 sessions a day.
• Take care of your mental health, and get support if you need it. Fecal incontinence can affect many aspects of your life, including your mental health. Talk to your doctor if you are feeling sad or anxious and it is not getting better. Support can also come from a counselor, support group, or trusted friend or family member.

Call your doctor now or seek immediate medical care if:

• You have new or worse pain.
• You have new or worse bleeding from the rectum.
• You have worse leaking of stool (incontinence).

Watch closely for changes in your health, and be sure to contact your doctor if:

• You cannot pass stools or gas.
• You do not get better as expected.