Fecal incontinence is the inability to control your bowels. When you feel the urge to have a bowel movement, you may not be able to hold it until you get to a toilet. Or stool may leak from the rectum unexpectedly, sometimes while passing gas.
More than 5.5 million North Americans have fecal incontinence. It affects people of all ages—children and adults. Fecal incontinence is more common in women and older adults, but it is not a normal part of aging.
Fecal incontinence can have several causes:
- Damage to the anal sphincter muscles
- Damage to the nerves of the anal sphincter muscles or the rectum
- Loss of storage capacity in the rectum
- Pelvic floor dysfunction
Effective treatments are available for fecal incontinence and can improve or restore bowel control. The type of treatment depends on the cause and severity of fecal incontinence; it may include dietary changes, medication, bowel training, or surgery. More than one treatment may be necessary for successful control because continence is a complicated chain of events.
You can adjust what and how you eat to help manage fecal incontinence.
- Keep a food diary. List what you eat, how much you eat, and when you have an incontinent episode. After a few days, you may begin to see a pattern involving certain foods and incontinence. After you identify foods that seem to cause problems, cut back on them and see whether incontinence improves.
- Foods and drinks that typically cause diarrhea, and so should probably be avoided, include:
- Drinks and foods containing caffeine
- Cured or smoked meat such as sausage, ham, or turkey
- Spicy foods
- Alcoholic beverages
- Dairy products such as milk, cheese, or ice cream
- Fruits such as apples, peaches, or pears
- Fatty and greasy foods
- Sweeteners, such as sorbitol, xylitol, mannitol, and fructose, which are found in diet drinks, sugarless gum and candy, chocolate, and fruit juices
- Eat small meals more frequently. In some people, large meals cause bowel contractions that lead to diarrhea. You can still eat the same amount of food in a day, but space it out by eating several small meals.
- Eat and drink at different times. Liquid helps move food through the digestive system. So if you want to slow things down, drink something half an hour before or after meals, but not with meals.
- Eat the right amount of fiber. For many people, fiber makes stool soft, formed, and easier to control. Fiber is found in fruits, vegetables, and grains. You need to eat 20 to 30 grams of fiber a day, but add it to your diet slowly so your body can adjust. Too much fiber all at once can cause bloating, gas, or even diarrhea. Also, too much insoluble, or undigestible, fiber can contribute to diarrhea. If you find that eating more fiber makes your diarrhea worse, try cutting back to two servings each of fruits and vegetables and removing skins and seeds from your food.
- Eat foods that make stool bulkier. Foods that contain soluble, or digestible, fiber slow the emptying of the bowels, including bananas, rice, tapioca, bread, potatoes, applesauce, cheese, smooth peanut butter, yogurt, pasta, and oatmeal.
- Get plenty to drink. Drink eight 8-ounce glasses of liquid a day to help prevent dehydration and keep stool soft and formed. Water is a good choice. Avoid drinks with caffeine, alcohol, milk, or carbonation if you find they trigger diarrhea.
Surgery to repair the anal sphincter may be an option for people who have not responded to dietary treatment and biofeedback and for those whose fecal incontinence is caused by injury to the pelvic floor, anal canal, or anal sphincter.