Bowel Incontinence Guide / HARTMANN Information Centre

The HARTMANN Team

Introduction

One of the most challenging barriers to finding the appropriate bowel incontinence products for you is being able to talk about bowel incontinence.  It is embarrassing, and it makes us feel vulnerable.  However, incontinence, particularly bowel incontinence, can be a sign that something more serious is happening.  It is also something that you should not need to live with.  It can seriously restrict your quality of life and therefore impact on your overall happiness and wellbeing.

It is time to set embarrassment and vulnerability aside and talk about the issues of bowel incontinence openly.  You have already searched for this article, so you have made an important first step.

What Is Bowel Incontinence?

Bowel incontinence is a loss of control over bowel function.  This means that you could pass material from your bowel unexpectedly.  This might be something small – like the involuntary passing of gas.  However, it can be as serious as the passing of liquid or complete loss of control over bowel movements.  You are more likely to recognise the signs and symptoms of urinary incontinence – with a lack of control of the bladder.  This is the same – but instead, it is for the bowel and material coming from the back passage.

There are lots of reasons why bowel incontinence may occur.  There can be an injury to the nerves that sense when you require a trip to the toilet.  Usually, the stool will press against this nerve and signal that the individual should act.  However, injury to the nerves in the rectum or those that control the anal sphincter can lead to bowel incontinence.  There are many reasons for such nerve damage – it can be caused by childbirth, or if you suffer from consistent constipation and strain during the process of passing stools.  Equally, it can be caused by spinal cord injury or even a stroke.

What Are The Signs and Symptoms of Bowel Incontinence?

There are symptoms that might signal bowel incontinence in adults. It is the regular occurrence of these issues that should alert you to potential problems – rather than individual incidents.

You may suffer from:

Diarrhoea: This is loose, watery stools that will appear quickly and with little warning.  You will find this difficult to hold in – much more difficult than the more solid stools you are used to.  This might mean you end up soiling yourself or you could leak material when passing wind.  This obviously makes everyday life difficult.

Constipation: Although incontinence suggests a loss of control over defecating, it might be a result of poor toilet habits in general.  It might be that you do not realise you need to go to the toilet at all.  You will then get a build-up of stool in the bowel, which you will interpret as constipation but could also be a lack of feeling in this area.

Passing wind: One of the earlier signs of bowel incontinence is an increase in the amount that you pass wind – and this may smell more than usual.  Embarrassing maybe, but also something that you should pay extra attention to should it continue.

Bloating: This is where our stomach may fill up with gas, and you will feel uncomfortable and maybe even feel painful.

Remember you should experience these symptoms regularly, and they should impact on your day-to-day life.  It is possible to have one-off incidents due to a virus or a reaction to food intake.  If these symptoms recur in a short period – this is when you should consider if you have bowel incontinence or not.

When Should You Seek Medical Advice?

The biggest problem with bowel incontinence is the shame and the sense of humiliation at the possible examinations you may undergo.  Many people do not seek help because they see it as something private or something embarrassing.  You need to remember that if this is adversely affecting your life, then you should see your GP.  They are used to seeing people who struggle with bowel movement – it is similar to asking a check-out operator the price of cornflakes – so there should be no embarrassment really.

There are two important points to remember when you are deciding whether to go to the GP or not.  First, it is unlikely to get better on its own.  If the problem has persisted for a time, then it is likely to continue and potentially get worse.  Secondly, it can be treated – and is not something you should just have to put up with on your own.  So, go, seek help – it is a sign of strength, not weakness to face such health issues.

If you are genuinely worried that you may never go to see your doctor for anything else ever again – once you have mentioned your bowel habits – then your local hospital may have an NHS continence service, you could access instead.

Toilet Paper Roll

What Causes Bowel Incontinence?

There are many reasons for bowel incontinence, some of which are serious, but some are not so serious at all.  It is best not to presume.  The most common reasons why you might struggle with bowel incontinence include:

Impacted stool: this is caused by severe constipation which in turn will cause you to strain and potentially damage nerves and muscles in the anal passage.

Long-lasting diarrhoea: this may be a result of irritable bowel syndrome (IBS) or similar.

Inflammatory bowel disease: conditions such as Crohn's disease or ulcerative colitis can cause bowel incontinence.

Haemorrhoids: these are commonly known as piles and when severe can result in bowel incontinence.

Colorectal Cancer: bowel incontinence could be a sign of cancer in the colon – and this is the primary reason why you should treat the symptom seriously and seek medical advice as soon as possible.

Nerve damage: not being able to feel that you need to pass a stool could be caused by nerve damage as a result of diabetes, spinal cord injury, MS or other similar conditions. This may also have resulted from childbirth, a stroke or spina bifida.

Radiation damage: if you have had treatment for prostate cancer you may consequently suffer from problems of bowel incontinence.

Whatever the cause it is not a good idea to try to work out yourself what may be causing your problems.  Bowel incontinence is a serious symptom and one that could indicate a more severe problem.  It is always best to seek medical advice.

How To Treat Bowel Incontinence.

The Medical Examination

 

One of the ways to overcome worries and concerns about bowel incontinence is to explain what happens when you go to the doctors.  What will you expect from the professional? If you know the steps that the doctor will take – it is unlikely to be as bad as if you imagine the experience.

When you first go to the doctors, there will be a need for a medical history to be taken and a physical examination to be performed. This physical examination will involve an inspection of your anus – and may include the insertion of a probe or a finger to check for nerve damage.  When this nerve is pressed the anal sphincter should contract, and your anus should pucker.  If this does not happen then your doctor will begin to assess the nature of the problem that you are facing. They may also assess if there any abnormalities – and ask you to bear down as if going to the toilet – to check the rectal prolapse.

You may then need to undergo further medical test. These tests could include a balloon expulsion test.  This sounds torturous – but isn’t at all.  This is where a small water-filled balloon is inserted into the rectum, and you are asked to go to the toilet to expel this.  If this takes more than three minutes, then the doctor may suggest a defecation disorder.  You may experience a tube inserted up the anal passage to take images of the anal passage or into the colon in its entirety. You may also be sent for an MRI scan.

None of these tests sound particularly pleasant, and it is understandable if you want to avoid the difficulties this may cause you.  However, the truth may be that you are putting off simple tests and in return, you may end up needing more complex procedures.  It is best to go to the GP as early as possible.

Can It Be Cured?

 

Bowel incontinence as a condition on its own can be treated, and the symptoms eased with careful management.  Therefore, it is highly likely that the medical professionals will be able to offer relief and a solution to potential underlying causes that have resulted in bowel incontinence.

There are lots of ways that the GP can help with this condition – depending on the root cause of the bowel incontinence, let’s break down some of the possibilities:

Medications: you may be given anti-diarrhoeal drugs such as Imodium or Lomotil.  This will ease the immediate unpleasant symptoms that are likely causing your most distress.  Alternatively, you can be given laxatives – if the cause for the incontinence is chronic constipation and you are weakening muscles in the area due to straining.

Dietary changes: everything that goes into your body impacts on your toilet habits and the consistency of any output.   This makes it common sense that the doctor may suggest that you change what you eat – including eating more fibre in your diet.  It is also likely you will be asked to drink plenty of fluids – and when they say fluids, they mean water or similarly hydrating liquids.  Be careful with tea and coffee that are considered diuretics, which means they have a dehydrating effect.

Exercise: if your incontinence is a result of muscle damage then you may be given exercises or physical therapy.  The aim of this therapy is to return control to the sphincter and control the urge to defecate.  There are some types of therapy that involve the application of devices – such as sacral nerve stimulation – which aims to regulate the sensation in the nerve that tells you when you need to pass stool.

Surgery: if the problem is ongoing and making life difficult and painful – then the doctors may suggest a surgery to correct any underlying problems causing the bowel incontinence.  This can include a procedure for repairing damage to the sphincter that may have occurred during childbirth.  It may mean correcting haemorrhoids or reversing a rectal prolapse.  In an extreme situation, the sphincter can be replaced by a device that essentially replaces its function.  If the problem is with the colon, as might be the case with something like Crohn’s disease, then there may be need for a colostomy – or a bowel diversion.

The amount of choice for treatment and management of this condition should be reassuring.  There are many ways that you can find the help you need – especially if you seek out this support quickly.

What Products Can Help?

 

Obviously, whilst you are going through tests and investigations into the root cause of your problems, you are still experiencing bowel incontinence.  Therefore, you need to enjoy support from products that can spare you the obvious embarrassment and the discomfort from the condition.  Here are some of the products we offer that can help you through this difficult time.

MoliNea® Rectangular Pads: These are pads that can be placed in your pants to collect material and ensure that there is no leakage.  These pads are waterproof and can come in different sizes depending on the seriousness of your issue.  Customers like to wear these because they are comfortable and discreet.  This is everything you would hope for at this time.

MoliCare® Premium FixPants: These are pants that can be used under or over your own underwear and with the use of the rectangular pads.  The point of these pants is to secure the pad in place and give you a sense of trust that nothing is going to move through the day.

MoliNea® Plus Underpads: You may struggle most at night, and therefore you need some protection for your bed.  These underpads serve to cover your sheet and offer the peace of mind needed for sleep.  These also come in Super Underpads for those with severe incontinence.

A possible area that goes under explored by some is the impact on the skin when someone suffers with bowel incontinence.  There is a need for sensitive wash lotion, like MoliCare® Skin Wash lotion  or bath lotions such as MoliCare® Skin Care bath.  Equally, there are products to help with convenience with cleansing – such as cleansing tissues.  All these products help deal with potential problems of discomfort and smells – especially as many of these products are pleasantly fragranced.

We understand the issue of bowel incontinence.  We know the potentials for leakage, for smells, for the discomfort from skin irritation.  All the products we design are here to support you until you can get a complete solution.

 

Summary

So, you have come to this article because you sense you have a problem and you are looking for information.  Well done.  Getting informed is a great starting point, and there are products we can deliver to you discreetly that will help with the day to day inconveniences of bowel incontinence.  The products will help with the leakages, the smells and the skin difficulties that you are likely to be experiencing.

This is a beginning to solving your problems.

The truth is that you now need to go to the doctors.  Remember not to self-diagnose.  Remember to not dismiss what you know you are experiencing.  It is not pleasant going through an anal medical examination – but it is likely something your doctor does several times a day.  The doctor may not even remember that this is odd or difficult for you.  They will pull on the gloves and lubricate the finger and then seek to work out why you are experiencing difficulties.  It is as simple as that for them – they will not change their mind about you as an individual.

The really good news is that most underlying causes of bowel incontinence – literally almost all of them – are simple to address.  You could be given medication, or exercises, or referred for surgery.  The treatments are highly successful.

It is always a good day when you can conclude an article on such a message of hope.  We hope that this information has helped you to know what to do now – and we look forward to supporting you back to a place of comfort and convenience.

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