Humans are unable to control their bowel movements during the first couple of years of life. But as their muscles become stronger and they receive the proper training, they eventually learn how to use the toilet whenever they need to expel feces. However, this ability sometimes starts to weaken as people enter their golden years. Though it may be embarrassing, this problem is common among elderly people.

The inability to control one’s bowel movements which results in the leakage of feces is known as fecal incontinence. Because this is seen as a socially embarrassing problem, sufferers of fecal incontinence may try to avoid discussing it with others close to them. They may also stop going to social gatherings and become isolated, which can lead to anger, depression, or loneliness. In addition, the skin around the anus can become irritated from repeated contact with fecal stools; which may cause itching, pain, and even ulcer formation in the area. Fortunately, there are numerous effective treatments available for fecal incontinence.

The bowels are controlled by a muscle called the anal sphincter muscle; and one of its functions is to prevent the leakage of stools out of the rectum. Because it can stretch significantly, the rectum has the ability to hold stools for some time (this is known as rectal storage capacity). But if the anal sphincter muscle gets damaged, fecal inconsistency can occur.

Common causes of anal sphincter muscle damage include constipation, rectal surgery for hemorrhoids; perirectal abscesses, inflammatory bowel disease, radiation-related injuries, and a reduction in muscle elasticity. Women who undergo an episiotomy (an incision to enlarge the vagina for easier childbirth) or who have their infants delivered with forceps are also more susceptible to injury or harm to their anal sphincter muscle. In addition, the nerves that control the anal sphincter muscle can become damaged due to conditions such as multiple sclerosis, spinal cord tumors, and diabetes.

Before a doctor can diagnose fecal incontinence, he or she must conduct a physical examination of the area between the anus and genitals to check for any infection or hemorrhoids. Blood tests and stool cultures are usually administered, and a digital rectal exam may be performed to check for abnormalities in the rectum. The doctor may also order other tests such as an anal manometry (which evaluates the tightness of the sphincter muscle), an anorectal ultrasonography (to inspect the structure of the sphincter muscle), and a proctography (to measure the rectal storage capacity). The physician can try to identify the cause of the fecal incontinence by conducting a proctosigmoidoscopy to check for swelling, infection, tumors, and scar tissue; or an anal electromyography to detect nerve damage in the anus.

A wide variety of treatments are available for fecal incontinence, including medications, dietary changes, special exercises, and surgery. One of the most common initial treatments is the prescription of an anti-diarrheal drug called ioperamide to check diarrhea or a laxative known as milk of magnesia to combat constipation. Stool-softening medications may also be taken by the patient to stop stool impaction.

The doctor may also tell the patient to embrace a high-fiber diet and consume plenty of fluids in order to relieve chronic constipation or prevent diarrhea. Such a diet may include whole wheat grains, bran, rice, cheese, and yogurt. It is a good idea for these patients to avoid caffeine and alcohol because they can exacerbate fecal incontinence.

In some cases, the physician may recommend bowel training if the patient is having trouble controlling his or her anal sphincter muscle. The patient will be told to evacuate his or her bowels at certain times (such as right after a meal). This will help condition the body to have bowel movements at the same time each day. Some doctors may conduct biofeedback, in which a probe is placed into the anus to measure the anal sphincter muscle’s strength. The patient can strengthen these muscles by engaging in daily anal sphincter muscle contraction exercises.

For some patients with severe fecal incontinence, the most favorable option may be undergoing surgery. A surgeon may have to surgically repair the anal sphincter muscle, remove hemorrhoids, or correct an anal protrusion. The physician may conduct a sphincteroplasty to help strengthen the anal sphincter muscle, or the muscle may be replaced entirely with an artificial sphincter. Another option is to inject biomaterials directly into the anal sphincter muscle in order to increase its size. As a last resort, a surgeon can perform a colostomy so that stools can be diverted through an opening in the abdomen.

People who have loved ones that suffer from fecal incontinence can help immensely by providing support and encouragement and helping these patients cope with their situation. This positive approach will help fecal incontinence sufferers feel better about themselves, which may spur them to seek treatment for their condition. If an individual is struggling with fecal incontinence, he or she should wear a disposable undergarment or pad and always carry a change of clothing whenever leaving home. Most importantly, senior citizens should understand that fecal incontinence is both a natural part of aging and a treatable condition - and that they shouldn’t feel self-conscious or ashamed about it.