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What to do if you notice changes in your bowel control
If you see changes in your bowel control, the first step is talking to your doctor. Most people feel uneasy talking about their stool, intestinal gas, or bowel movements. But doctors understand that these are very normal and necessary processes in all of us.
Doctors and other therapists are there to help when bodily processes go wrong. So the first very important step is to talk plainly about the problems you are experiencing.
Talk about symptoms
Begin by describing your troubling symptoms. Be specific so your doctor (or therapist) clearly understands the problem. Here are some examples:
- Diarrhea – Diarrhea is a common factor that can cause incontinence. If you are experiencing loose or runny stool that is leaking, do not simply say to your doctor that you, “have diarrhea.” That does not tell the doctor that you are losing control of the stool. Be clear, “When I have diarrhea it leaks into my clothing with little or no warning. I can’t stop it in time to get to the toilet.”
- Constipation – You may be surprised that constipation is another common factor that can lead to incontinence. Hard stool stuck in the rectum can build up to the point where watery stool leaks around it. Be sure to tell your doctor if you are constipated – not simply that you, “have leakage of loose stool.” Your doctor might naturally think you have diarrhea and prescribe a treatment that makes you even more constipated. Be clear about any changes in your bowel habit, such as ongoing constipation or diarrhea.
- Pain – Continually squeezing together the muscles around your rectum, because of fear that stool may leak, can cause the muscles to cramp and get tired. The result will be pain, which can be severe, and muscle weakness. Both will make your incontinence worse. If this is happening to you, explain it to your doctor.
Talk about effects
Next, let your doctor know how this is affecting your daily life. Ask yourself this question, “How have my bowel control problems changed my life?”
The answer, such as, “I’m afraid to leave my house” or “I don’t socialize anymore” is important information for your doctor. These kinds of changes may have come on gradually. They are important for you to recognize. This is your own personal test of how serious your disorder is.
How often you experience incontinence is not always as important as how the problem has changed your life. A goal of your treatment will be to help you get back, as much as possible, the parts of your life that have been lost because of incontinence.
If you have lost sensation, you may have no feeling of the urge to pass gas or stool. Knowing you may experience incontinence with no warning, at any time, may mean that you are worried about it all the time. This can be a heavy burden that takes a toll on daily life. Be sure to explain this to your doctor as well.
Talk about history
Your doctor will want to know how long you have been experiencing episodes of incontinence and if it has been getting worse or has changed over time. Other things to tell your doctor about include:
- Any other illnesses that may be affecting your health
- A list of all medicines you are taking, including
- Prescription and over-the-counter
- Herbal supplements
- Vitamins or mineral supplements
- How much and how often you take any of these
- Any surgeries you have ever had in the past
If you are a woman who has given birth, even many years ago, let your doctor know. Tell your doctor:
- How many children you had by vaginal delivery
- How many hours you were in labor
- If you had an episiotomy (a cut the doctor sometimes makes in the vaginal area)
- If forceps were used
- If you had any tearing that needed surgical repair
Any of these factors could play a part in damage to nerves and muscles, which then get weaker or less able to do their job with age. The resulting problems affecting continence may take many years to show up.
Talk about treatments
Your doctor may want to run tests before coming up with a treatment plan. Various tests can look at how well the organs, muscles, and nerves that affect your continence are working. They can also look for signs of disease or injury. The doctor should explain to you:
- The reason for the test
- What to expect during and after the test
If you do not understand something, be sure to ask.
Be sure to talk to your doctor about all treatment options, possible risks, and chances of success. Think about what “success” means to you. Does it mean cure; or does it mean managing symptoms so you can get on with your life?
A cure may not be possible. Treatments may have their own set of side effects. It is important that you understand your options and work with your doctor or therapist to set your own treatment goals.
Points to remember
There are ways to help manage incontinence. The first step is to recognize that something is wrong and seek help.
Doctors do not receive much training about bowel incontinence in medical schools, and no type of doctor specializes in treating bowel incontinence. Start with your primary care physician.
It is important that when you talk to a doctor about your incontinence he or she respond to you with interest and concern. If that does not happen, it is reasonable for you to consider finding another doctor.
Your doctor or therapist may not have all the answers. Much remains to be learned about the condition, but he or she should listen to you and work with you to find existing solutions that work best for you.
Working together you can set treatment goals to improve function – both in your body and in your daily life.
Remember, you are not alone. Don’t suffer in silence. Talk to your doctor and get help.
Adapted from IFFGD Publication: Talking To Your Doctor About Incontinence by William F. Norton, Publications Editor, International Foundation for Functional Gastrointestinal Disorders, Milwaukee, WI.