How to control accidental bowel leakage

Hema Brazell, MD

Urogynecology

Accidental bowel leakage is a topic you may be too embarrassed to talk about, even with your doctor. But talking to your doctor is an important first step in managing your condition and improving your daily life. OB/GYN physician Hema Brazell, MD, shared information about accidental bowel leakage along with what non-surgical treatment options are available.

What is accidental bowel leakage?

Accidental bowel leakage (ABL) is involuntary loss over bowel control and includes leakage of both stool and gas. It not only reduces quality of life, but also negatively impacts emotional and mental well-being. The most common cause of ABL is loose/diarrheal stools. However, some women suffer from ABL after childbirth due to damage to the muscles and nerves which otherwise help maintain control over your bowels. These changes can occur early in the postpartum period or manifest later in life. 

“Always discuss bowel leakage after a delivery with your gynecologist. Oftentimes there is not an explainable cause other than childbirth. However, sometimes there is an underlying delivery-related issue which needs to be addressed,” said Dr. Brazell.

How is ABL treated?

Depending on the cause of ABL, there are many treatment options. “Treatment requires patience to find what works best. Sometimes we need to use a combination of strategies. In general, however, fiber and water are your friends,” said Dr. Brazell.  Many times, treatment can be started without any testing other than a physical exam. There are several non-surgical treatment options available to help you manage ABL, including:

Dietary changes

• Keep a food diary to see if certain foods/beverages cause an episode (common problem foods include caffeinated beverages, sweeteners and dairy)
• Aim for 25–35 grams of fiber daily (psyllium, wheat dextrin, methylcellulose)
• Drink plenty of water (fiber does not work without water)

Behavioral changes

• Practice strengthening your pelvic floor muscles with Kegel exercises
• A bowel schedule – reserve time after meals for your bowels to empty, but do not strain
• Consider pelvic floor physical therapy from trained therapists in pelvic floor disorders

Medications

• If your stools are loose, consider taking loperamide. Be sure to talk to your doctor if this an option you are considering as it is important to find a balance and avoid constipation.

Most importantly, if you are suffering from ABL, talk to your doctor. “There is help out there for you and it’s important to know that you aren’t alone,” said Dr. Brazell.