question: Embarrassingly, I sometimes leak stool. Is this common? Is there a way to stop it?

answer: We talk about this topic so much that it makes you wonder if there’s anyone who hasn’t pooped in their pants in their adult life, or experienced accidental bowel leakage or fecal incontinence, as medical terms call it. Many people are very shy.

It’s more common than you think: a study Based on data from the National Health and Nutrition Examination Survey, approximately 8 percent of U.S. adults suffer from fecal incontinence.

There are many things that people don’t talk about themselves, so I try to ask the patients directly because there are effective treatments.

Increasing your dietary fiber is one of the first things I recommend. Three of my colleagues at Massachusetts General Hospital were part of a group studying this. A study of approximately 60,000 older women found that a high-fiber diet was associated with obesity. Reducing the risk of fecal incontinence.

Although it sounds counterintuitive, fiber can help increase the volume of loose stools and increase the absorption of water by the colon. It is also effective against constipation, which is a common cause of fecal incontinence due to diarrhea.

Also found in analysis of the same cohort Eating more foods that promote inflammationProcessed meats and sugary carbonated drinks were associated with a higher risk of fecal incontinence. The authors hypothesized that pro-inflammatory foods may negatively interact with the gut microbiome and reduce the function of pelvic floor muscles and nerves.

Of all the things you’ve heard about these foods, this is a very motivating reason to minimize their intake.

Besides constipation, fecal incontinence can be caused by common underlying issues such as diarrhea, irritable bowel syndrome, inflammatory bowel disease, and lactose intolerance. It can also be a sign of certain health conditions, such as diabetes or neurological problems.

However, there may be no underlying “diagnosis” causing fecal incontinence. In some cases, things we do unconsciously, such as side effects of medications (including antibiotics) or aggravators in our diets such as artificial sweeteners, which cause looser, more urgent stools that are difficult to control. It can be a trigger.

The chance of developing an accidental leaky bowel increases with age.Some of that risk is related to Changes in muscles and nerves that occur with aging This makes it difficult to notice the presence of stool and contain it. Some elderly people Dementia and decline in motor skills You are more likely to experience fecal incontinence, but higher levels of physical activity You can lower them.

Given the above, I do not consider frequent fecal incontinence to be “normal”, regardless of age.

Although there has been much debate in the medical literature as to whether birth-related injuries increase risk, some studies have shown that they do indeed cause fecal incontinence. affects men and women alike.

I know, so it’s a little confusing Women are more likely to seek care than men About leaky gut from doctors and some women. Especially if there are lacerations or forceps are required for delivery., experience it in the first few months after giving birth. But the data aren’t clear whether birth-related injuries can lead to her fecal incontinence 20 or 30 years later.

menopausal hormone therapy is shown There is a slight increase in the risk of fecal incontinence with longer treatment periods, possibly due to the effects of estrogen on the pelvic floor. (My colleagues at Massachusetts General Hospital were also part of this research group.)

When patients come to me about this, I ask about patterns of incontinence. This reveals her two common reasons why incontinence occurs. One is a problem with the muscles and nerves of the pelvic floor, and the other is a problem with stool quality.

Does leaky gut occur passively, sometimes without you even realizing it? It could indicate a pelvic floor problem that can be treated by a professional.

Does it happen with a sense of urgency, feeling like you want to go to the bathroom right now but won’t be able to make it in time? It could be related to intestinal disorders such as diarrhea, which can respond to medications.

Depending on your medical history, your doctor may want to do additional tests for diseases that can change the quality of your stool and increase your risk of incontinence. We may also perform a physical exam and special tests such as: Anorectal pressure measurement or an MRI scan to more accurately assess the pelvic floor.

Your doctor may identify other pelvic floor problems that cause urine leakage, such as prolapse, which may require surgery to correct. Pelvic floor muscle dysfunction may be helped by biofeedback, a special type of physical therapy that involves inserting a probe into the anal canal to analyze how the pelvic muscles move during defecation.

I get it. But pelvic floor physical therapy is more weird than uncomfortable – and it works!

What we want patients to know

The social consequences of fecal incontinence can be devastating. That’s why starting a conversation about it is the hardest, but most important step to not only understanding what’s going on, but improving your quality of life.

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