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Suffering from fecal incontinence. Rectal leakage after bowel movement. Taking immodium. Having flatulence. Suggest remedy?

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General & Family Physician
Practicing since : 1970
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I m 58 year old female who has been dealing with fecal incontinence for over 14 years. What usually happens is that I will have a bowel movement and if the stool is soft, I have rectal leaking after the bowel movement. This can happen several times within 2 hours and I wear maxi-pads to protect my underwear. The leaking is usually about a teaspoon or a table spoon at a time. When I have formed stool, small pebble size stools with "escape" my rectum. Dark leafy greens seem to aggravate the situation. Some times there is no rhyme or reason. Immodium really helps slow things down, but my health practitioner says this is a bad treatment that can cause other problems. I also have a lot of flatulence and my symptoms are also worsened when I eat lugumes. I have gone gluten, egg, soy and dairy free and this has had no effect on my symptoms. I have tried using fiber capsules with mimimal results. Suggestions? Should I got to a gastroenterolgist? I don't want surgery but it seems I am running out of good options and treatments. Thank you for your time.
Posted Sun, 27 Oct 2013 in Digestion and Bowels
Answered by Dr. Vasudha Jayant Athavale 4 hours later
Brief Answer:
Try sphincter exercises, nerve stimulation

Detailed Answer:
Thanks for the query.
Fecal incontinence is treatable.There is no point in making life miserable. The treatment depends on causative factor.
* -Mostly it is due to damage of anal sphincter muscle fibers or pelvic floor weakness.
Pelvic exercises (especially for anal sphincter ) do help in strengthening the sphincter. These exercises are to be accompanied by dietary changes to avoid constipation( straining & further damage to sphincter.)
- Surgically implanted sacral nerve stimulation sometimes proves to be better than pelvic floor exercises.
* -Nerve damage during surgery, child birth May cause the problem.
In such cases,
-In some patients,Trans cutaneous nerve stimulation is helpful .
* Surgery is the final treatment. It is better to have surgical option, if every thing else fails.
There are various options available , Surgeon selects one or combination of the methods considering the patient's requirement.
I hope, the answer has satisfied you. Any further query is welcome.
Thank you.
Above answer was peer-reviewed by
Follow-up: Suffering from fecal incontinence. Rectal leakage after bowel movement. Taking immodium. Having flatulence. Suggest remedy? 23 hours later
Can you direct me to a website or give me directions on the pelvic floor exercises?
Answered by Dr. Vasudha Jayant Athavale 1 hour later
Brief Answer:
Kegel's exercise with Bahya Pranayama will help.

Detailed Answer:
Thanks for the query.
There are many web sites for pelvic floor exercises, but I want to tell you specific exercises for anal sphincter tightening.
These exercises are to be done only after bowel evacuation.
1) Kegel's exercise for anal strengthening-
* Exhale completely while-
-Abdominal muscles are loose,
- Anus is relaxed
* Inhale deeply while,
Abdominal muscles are pulled in, tight.
- Anus is pulled up,
- Anal sphincter is closed as tightly as you can.
Both the stages are to be repeated 20 to 30 times in a day.
2) 'Bahya pranayama'- it is a yoga posture achieving sphincter control.
- Exhale completely & maintain it as long as you can. During this period-
_ tighten abdominal muscles, pull them in
- pull anus up
- close anal sphincter as tightly as you can
Retain all the things as long as you can. Gradually the time should be increased to 30 seconds.
Hope you are satisfied with the answer.
Above answer was peer-reviewed by
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