Bowel incontinence

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Digestive system

Inflatable artificial sphincter

Formula tube feedings often cause diarrhea and bowel incontinence. For diarrhea or bowel incontinence that is occurring because of tube feedings, consult your health care provider or dietician. The rate of the feedings may need to be changed, or bulk agents may need to be added to the formula.

FECAL IMPACTION

Constipation or fecal impaction may also contribute to fecal incontinence. Loss of rectal muscle tone may result in leakage of watery, liquid stool around the fecal impaction. Usually once a fecal impaction has developed, laxatives and enemas are of little help. In this case a health care provider will insert one or two fingers into the rectum and break the mass into fragments so that it can be expelled.

Measures should be taken to prevent further development of fecal impaction. Fiber should be added to the diet to help form normal stool. In addition, drinking enough fluids and getting enough exercise may enhance normal stool consistency.

OTHER THERAPY

When a person has frequent bowel incontinence, special external fecal collection devices may be used to contain the stool and protect the skin from breakdown. These devices consist of a drainable pouch attached to an adhesive wafer. This wafer has a hole cut through the center which fits over the anal opening.

Most people who have bowel incontinence due to a lack of sphincter control, or decreased awareness of the urge to defecate, may benefit from a bowel retraining program and exercise therapies aimed at restoring normal muscle tone.

Special care must be taken to maintain bowel control in people who have a decreased ability to recognize the urge to defecate, or who have impaired mobility that prevents them from independently and safely using the toilet. Assist the person to use the toilet after meals, and promptly respond to the person's request to use the toilet.

If toileting needs are often unanswered, a pattern of negative reinforcement may develop. In this case the urge to defecate is no longer associated with appropriate actions. See also toileting safety.