Bowel incontinence

Uncontrollable passage of feces; Loss of bowel control; Fecal incontinence; Incontinence - bowel

Treatment of bowel incontinence should begin with identifying the cause of the incontinence. There are several ways to help achieve normal bowel function and strengthen the rectal muscles.

MEDICATIONS

In people with bowel incontinence due to diarrhea, medications may be used to control the diarrhea. This may correct the bowel incontinence. Loperamide (imodium) has antidiarrheal properties and improves the condition of the rectal muscle.

Other antidiarrheal medications include cholinergic medications (belladonna or atropine), which decrease intestinal secretions and movement of the bowel. Opium derivatives (paregoric or codeine) increase intestinal tone and decreases movement of the bowel, and diphenoxylate (lomotil) decreases movement of the bowel and slows the movement of stool through the bowel.

Other medications used to control bowel incontinence include medications that reduce the water content in the stools (activated charcoal or Kaopectate), protect the intestinal lining from irritation (amphogel or Pepto-Bismol), or absorb fluid and add bulk to the stools (Metamucil).

MEDICATION EVALUATION

With your health care provider, review all the medications you take. Certain medications can cause or increase the frequency of bowel incontinence, especially in older people. These medications include:

• Sedatives and hypnotics
• Laxatives
• Narcotics
• Antacids
• Muscle relaxants

SURGERY

People who have bowel incontinence despite medical treatment may need surgery to correct the problem. Several different options exist. The choice of which type of surgery will be based on the cause of the bowel incontinence and the person's general health.

RECTAL SPHINCTER REPAIR

Sphincter repair is performed on people who have a rectal sphincter (muscle ring) that isn't working well as a result of injury or aging. The procedure consists of re-attaching the rectal muscles to tighten the sphincter and increase the capacity of the anus.