What if you get bowl leakage or incontinence?

What is bowel leakage or incontinence?

Bowel leakage or incontinence is caused by the loss of regular control of the bowels causing involuntary leakage to occur.

What can cause bowel leakage or incontinence?

• Surgery which involves removing a part of the bowel.
• Surgery can affect the normal working pattern of the bowel.
• Surgery can also affect the sensitivity of the nerve endings in the back passage that tell you whether it is wind or stool waiting to come out.
• Very rarely there can be some damage to the muscle which forms the entry into your back passage.
• Diarrhoea or loose stool, which is more difficult to control.
• Some foods or medicines affect how loose or firm your stool is.

Hints and tips

The following exercises may help you to retrain your bowel control:

• If you feel any pressure or filling sensation in your back passage try not to panic. Tensing all your muscles, holding your breath or rushing to the lavatory can make things worse. Instead sit or stand still, breathe deeply and tighten the muscles (sphincter muscles) around your back passage until the urge passes.
• Imagine that your sphincter muscle is a lift. When you squeeze as tightly as you can, your lift goes up to the fourth floor. It will not stay there very long because it has used up all its energy getting there. Likewise, squeezing as tightly as you can won’t get you safely to the lavatory because the muscle will get tired very quickly. So now squeeze more gently and take your lift only up to the second floor. Feel how much longer you hold it at that level. You may not be able to do this at first so practice the exercise at times when you do not want to empty your bowels.
• Sit on the lavatory and hold on for as long as you can before opening your bowels. Don’t worry if you can only manage a few seconds, it will become easier with practice. Try to relax and concentrate on breathing very calmly. It may be helpful to take something to read.
• Once you can delay opening your bowels for a few minutes, the unpleasant urge to go will improve. Get up and leave the lavatory. Return a few minutes later when there is no urge and try to open your bowels.
• The longer you can hold on, the more fluid is absorbed from the stool, and firmer stools can help to reduce urgency.

The following exercises may help to strengthen your sphincter muscles:

• Sit, stand or lie with your knees slightly apart and imagine that you are trying to stop yourself passing wind. To do this you must squeeze the muscles around your back passage. Try squeezing and lifting the muscles as tightly as you can as if you are really worried that you are about to leak. You should be able to feel the muscles move. Your buttocks, tummy and legs should not move much at all. You should be aware of the skin around your back passage tightening and being pulled up and away from your chair. You should not need to hold your breath when you tighten these muscles.
• Tighten and pull up the sphincter muscles as tightly as you can. Hold on for at least five seconds and then relax for at least ten seconds. Repeat at least five times. This will work on the strength of your muscles.
• Pull the muscles up to about half of their maximum squeeze. See how long you can hold this. Then relax for at least ten seconds. Repeat at least five times. This will work on the endurance or staying power of your muscles.
• Pull up the muscles as quickly and tightly as you can, relax, then pull up again. See how many times you can do this before you get tired. Try for at least five minutes.

Do these exercises at least ten times every day. Your control and confidence will gradually improve. You may need to do these exercises regularly for several months before the muscles gain their full strength and you regain regular bowel control. If necessary, a referral to a continence advisor can be made. He or she has specialist knowledge in helping people overcome problems with bowel control.