Bowel incontinence

You might have bowel incontinence if you cannot control when you poo. Symptoms of bowel incontinence include: poo leaking out without you being able to stop it feeling like you need to poo, but not being able to get to the toilet in time not being able to get fully clean after going to the toilet seeing streaks or stains of poo in your underwear

If a GP thinks you might have bowel incontinence they: will talk to you about your symptoms might ask to examine you by feeling your tummy (abdomen) and feeling inside your bottom with a finger (they'll be wearing gloves) might ask you to give a poo sample They might refer you to a specialist for more tests such as: blood tests a colonoscopy (a test to check inside your bowels using a thin, flexible tube with a small camera inside it) an ultrasound scan

The treatment you have for bowel incontinence will depend on what's causing your symptoms and how severe they are. Treatment from a GP A GP might recommend: a review of your diet and any medicines you take medicines to make you poo less often, such as loperamide , or medicines to soften your poo (laxatives) products to help with bowel incontinence, such as incontinence pants, or pads for inside your clothes or on your bed plugs that go inside your bottom to stop leaking (anal plugs) – the doctor will explain how to use these products to protect your skin, such as barrier cream or ointment – they may also give you advice on how to keep your skin clean If these things do not help, they might refer you to a specialist service. Treatment from a specialist service A specialist incontinence service can: review your diet and any medicines you take recommend exercises to strengthen your pelvic floor and the muscles around your bottom (biofeedback) recommend techniques to help you empty your bowels fully and develop a controlled routine for emptying them (bowel retraining) If these things do not help, you might be referred for surgery. Surgery for bowel incontinence You may have surgery if other treatments have not helped or your symptoms are severe. Surgery can include: repairing your muscles in your bottom that control when you poo (anal sphincter) making a new anal sphincter using muscle taken from your thigh putting an artificial sphincter in your bottom, so you can control when you poo putting a small device under your skin in your bottom that uses electrical pulses to help you control when you poo having a small tube (catheter) put into your tummy through a small hole to flush water through, which helps empty your bowels making a small opening in your tummy (stoma) to attach a pouch to collect your poo The surgeon will explain the risks and benefits of the operation, and what will happen.

The GP or specialist may recommend lifestyle changes that can help manage bowel incontinence. Do try changing the position you sit in while pooing, such as using a squatting position – put your feet on a footstool while you sit on the toilet, so your knees are higher than your hips, and lean forward slightly try to poo at regular times, such as after meals keep a diary of your symptoms and what you eat and drink – you may notice some things make your bowel incontinence worse, such as caffeine, alcohol, spicy food or too much fibre plan an easy route to the toilet at home and when you're out wear clothing that's easy to get off if you need to use the toilet in a rush practise any exercises your doctor has recommended for your pelvic floor or muscles around your bottom eat a balanced diet quit smoking – nicotine can affect how quickly food moves through your digestive system Don’t do not cut lots of foods and drinks from your diet at once – try one thing at a time to see if it helps your symptoms try not to strain when you poo Information: Get a RADAR key RADAR keys unlock lots of accessible public toilets in places like cafés, restaurants and shopping centres. It might help to get one so you can easily access a toilet when you're in public. You can usually get one from a charity.

Get help from NHS talking therapies Having bowel incontinence can affect your mental health. It can help to talk about how you're feeling. You can get talking therapies for free on the NHS. These services can help you find ways to cope. Help is available in person, by video, over the phone or as an online course. Find NHS talking therapies for anxiety and depression Support from charities There are also national charities that can offer support and information about bowel incontinence. Bladder & Bowel Community Information and support for people with bladder and bowel conditions. Website: www.bladderandbowel.org Email: help@bladderandbowel.org Bladder & Bowel Community: online contact form Bladder & Bowel Community: online support services Bladder & Bowel Community: Facebook support group Bladder & Bowel UK Information and support for people with bladder and bowel conditions. Website: www.bbuk.org.uk Helpline: 0161 214 4591 Bladder & Bowel UK: online contact form

Bowel incontinence can happen for lots of reasons and is common. Try not to be embarrassed. You may get it for reasons such as if you: eat certain foods or drinks, for example spicy foods or drinks with caffeine in them have weaker muscles around your bottom – this can happen as you get older or because of things like hormonal changes or childbirth have a health condition that affects your digestive system such as constipation, irritable bowel syndrome (IBS) or Crohn's disease have a health condition that makes you less aware of when you need to poo, such as dementia, a learning disability, a stroke or damage to the nerves in your spine It can be a result of more than one of these things. Children can also get bowel incontinence. Sometimes they avoid going to the toilet, which means their poo hardens and runny poo leaks out, or they do not make it to the toilet in time.