Treatment for bowel incontinence begins with more conservative therapies as prescribed by a gastroenterologist (GI). Often called first line therapies, your GI doctor may prescribe one or more of the following treatments:
Depending on your diagnosis and the confirmed cause of the bowel incontinence, your GI doctor may prescribe medications such as anti-diarrheal drugs, or laxatives if chronic constipation is causing your issue.
Behavioral techniques and lifestyle changes
- Diet modification – Certain foods can affect your bowel more than others, which is why your doctor may recommend drinking more fluids (especially water, but not cola or sugary drinks) and adding more fiber-rich foods to your daily diet such as whole grains, beans and fresh fruits and vegetables. These diet modifications aid in better digestion, which in turn alleviates constipation. Adding more fiber to your diet also adds bulk to your stools which minimizes bouts of diarrhea.
- Bowel training – Sometimes done in combination with medications and diet modification, your GI doctor may recommend bowel training, where you try to train your body to have a bowel movement at a specific time of day. Creating a schedule for going to the bathroom can help you control your bowels more effectively over time.
Physical therapy is beneficial for patients who have muscle damage that is causing their bowel incontinence. Specially trained pelvic floor physical therapists will focus on developing a personalized program of exercise and other strengthening therapies to restore muscle tone to the pelvic floor muscles that control the bowels. These therapies can help improve anal sphincter control and the awareness of the urge to defecate. In addition to bowel training (above), physical therapists provide a therapy called biofeedback.
- Biofeedback therapy - Working with a pelvic floor physical therapist, you will learn specific exercises that target and help strengthen the anal sphincter muscles. Stronger pelvic floor muscles can help you sense when stool needs to be released and also help to contract the muscles when you need to hold the bowels until you can get to a bathroom. The goal of biofeedback therapy is to improve anal sphincter control and to help you better control bowel urgency.
When more conservative therapy is not effective in managing bowel incontinence and symptoms either do not improve or continue to worsen, your gastroenterologist will refer you to one of the bowel incontinence and InterStim therapy specialists at Chesapeake Urology to determine whether you are a candidate for InterStim neuromodulation therapy for bowel incontinence.