Bowel Leakage is the #1 embarrassing pelvic floor complaint no one wants to talk about!
Among all the ways pelvic floor issues can manifest, bowel leaking definitely causes the most embarrassment. An estimated 7-15% of women experience accidental bowel leaking (Bharucha et al, 2015). The actual rates of bowel leaking may be higher due to providers not routinely enquiring about it, and patients not sharing it with their providers due to embarrassment.
Industry experts are recognizing the need for routinely screening women for this bothersome complaint to avoid longstanding suffering. It’ll be helpful for the reader to know that bowel leaking can often be resolved by simple lifestyle changes and exercise. For more complicated situations, medical & surgical interventions may be necessary.
Common Causes of Bowel Accidents
The most common causes for bowel leaking may include one or more of the following –
1. Chronic Constipation – Yes, you read that right! If someone suffers from chronic constipation (less than 3 bowel movements a week, passing stools that are hard & cracked, or needing laxatives routinely to clear bowels), they are at a higher risk of developing bowel leaking.
When there is hard stool in the rectum & end of the colon that hasn’t been cleared out , new waste matter that fills in the colon can be pushed through this hard fecal matter causing Overflow Incontinence or Fecal Seepage.
2. Birth Injuries – Vaginal birth tears, especially Grade 4 tears which go from the vaginal opening to the anus frequently lead to leaking of stool. Stool leakage can also occur in women who have a rectal prolapse, or less severe birth-related perineal injury.
3. Nerve injuries and surgery – Conditions that affect the brain or the spinal cord, such as – dementia, stroke, and spinal cord injury – can affect the successful control of the anus sphincter muscle, which can lead to bowel leakage. Leakage of stool can also be a side effect of surgeries for repairing hemorrhoids or the anus sphincter itself.
4. Pelvic Floor Weakness – Last, but not the least, insufficient pelvic floor strength, poor pelvic floor coordination, and pelvic muscle tightness can be causes of stool leaking. These causes are often behind the stool leaking experienced by physically fit individuals like runners, cyclists, or weightlifters, who occasionally experience stool leaking when engaging in their sport of choice.
Strategies to manage Bowel Leaks
The easiest solution to decrease bowel leakage is to ensure a regular toileting schedule with the passage of smooth stools without straining, or the need for laxatives or stool softeners. It is also important to have consistency with the time of bowel emptying. A gut that empties on an inconsistent schedule is a gut that is not functioning optimally.
Improved bowel control can be achieved by:
– Eating a healthy diet with fiber from fruits, vegetables, nuts & whole grains.
– Supplementing dietary fiber with products like metamucil,citrucel, or benefiber that soften & bulk up stool for easy passage. Ensure to consume the recommended amount of water with fiber supplements to avoid further constipation.
– Hydration is the easiest way to improve your toileting habits. Aim to consume water (in oz) that is approximately half your weight in lbs. For instance, a woman who weighs 150 lbs should ideally consume approximately 75 oz of water each day.
Another method to improve toileting ease and decrease leaking is to empty your bowels fully each time by using good posture & biomechanics while on the toilet. A toileting stool such as the squatty potty, is a great aid to a healthier bowel. You can also use the pelvic floor relaxation techniques taught in the video below.
If you continue to experience Bowel Leakage after trying these easy strategies, schedule a consult with our pelvic floor therapist. More often than not, we can help you solve your bowel issues without the need for medications or surgery!
