Bowel Incontinence

Bowel Incontinence Introduction

Bowel incontinence is the inability to control bowel movements. It's a common problem, especially among older adults.

Bowel incontinence is usually not a serious medical problem. But it can seriously interfere with daily life. People with bowel incontinence may avoid social activities for fear of embarrassment.

Many effective treatments can help people with bowel incontinence. These include:

  • medicine
  • surgery
  • minimally invasive procedures

Talking to your doctor is the first step toward freedom from bowel incontinence.

Bowel Incontinence Causes

The most common cause of bowel incontinence is damage to the muscles around the anus (anal sphincters). Vaginal childbirth can damage the anal sphincters or their nerves. That's why women are affected by bowel incontinence about twice as often as men.

Anal surgery can also damage the anal sphincters or nerves, leading to bowel incontinence.

There are many other potential causes of bowel incontinence, including:

More than one cause for bowel incontinence is frequently present. It's also not unusual for bowel incontinence to occur without a clear cause.

Reviewed on 2/9/2012

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Bowel Incontinence Care

What if a child has bowel incontinence?

A child with bowel incontinence who is toilet trained should see a health care provider, who can determine the cause and recommend treatment. bowel incontinence can occur in children because of a birth defect or disease, but in most cases it occurs because of constipation.

Children often develop constipation as a result of stool withholding. They may withhold stool because they are stressed about toilet training, embarrassed to use a public bathroom, do not want to interrupt playtime, or are fearful of having a painful or unpleasant bowel movement.

Similarly to adults, constipation in children can cause large, hard stools that get stuck in the rectum. Watery stool builds up behind the hard stool and may unexpectedly leak out, soiling a child's underwear. Parents often mistake this soiling as a sign of diarrhea.

Anal Discomfort

Steps that help relieve anal discomfort:

  • Washing the anal area after a bowel movement. Washing with water, but not soap, can help prevent discomfort. Soap can dry out the skin, making discomfort worse. Ideally, the anal area should be washed in the shower with lukewarm water or in a sitz bath. No-rinse skin cleansers, such as Cavilon, are a good alternative. Wiping with toilet paper further irritates the skin and should be avoided. Premoistened, alcohol-free towelettes are a better choice.
  • Keeping the anal area dry. The anal area should be allowed to air dry after washing. If time doesn't permit air drying, the anal area can be gently patted dry with a lint-free cloth.
  • Creating a moisture barrier. A moisture barrier cream that contains ingredients such as dimethicone - a type of silicone - can help form a barrier between skin and stool. The anal area should be cleaned before applying barrier cream. Patients, however, should talk with their health care provider before using anal creams and ointments.
  • Using nonmedicated powders. Nonmedicated talcum powder or cornstarch can also relieve anal discomfort.
  • Using wicking pads or disposable underwear. Pads and disposable underwear with a wicking layer can pull moisture away from the skin.
  • Wearing breathable clothes and underwear. Clothes and underwear should allow air to flow and keep skin dry. Tight clothes or plastic or rubber underwear that blocks air can worsen skin problems.
  • Changing soiled underwear as soon as possible.

SOURCE:
NDDIC. Fecal Incontinence

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