Fecal incontinence

What is fecal incontinence?

Fecal incontinence is defined as the involuntary loss of liquid or solid stool, and gas. It can also be associated with fecal urgency, which is a sudden and urgent need to have a bowel movement.

What are the causes of fecal incontinence?

Fecal incontinence can be caused by weakened pelvic floor muscles, a reduced sensation of needing to have a bowel movement, or a change in the ability to hold stool.

Certain factors can increase the risk of developing fecal incontinence:

• Pregnancy and vaginal childbirth (grade 3 and 4 tears);
• Lifestyle habits (e.g., diet, hydration, etc.);
• Organ prolapse (pelvic prolapse);
• Chronic constipation and diarrhea;
• Perimenopause and menopause;
• Anorectal and/or colorectal surgery or trauma;
• Certain medical conditions (e.g., diabetes, chronic lung diseases, Parkinson's, multiple sclerosis, etc.);
• Medication and other medical treatments (e.g., hormone therapy, radiotherapy, etc.);
• Aging and age-related loss of autonomy.

We understand this issue and treat it frequently.

What are the symptoms of fecal incontinence?

• Leakage of solid or liquid stool;
• Difficulty or inability to hold gas;
• Difficulty completely emptying bowels;
• Constipation (overflow incontinence);
• Soiling or leakage after a bowel movement;
• Prolonged wiping after a bowel movement.

How is fecal incontinence diagnosed?

Diagnosis is made through a subjective and physical examination in the clinic. There are also medical tests that can be prescribed by a doctor.

How can physiotherapy help with fecal incontinence?

Your perineal and pelvic floor physiotherapist will first conduct a comprehensive assessment (e.g., lifestyle habits, posture, breathing, contraction/relaxation of pelvic floor muscles, etc.) to determine the cause(s) of fecal incontinence.

Based on the assessment results, your physiotherapist will:

• Will offer personalized advice related to your lifestyle habits;
• Provide advice on defecation techniques and positions;
• Provide you with specific exercises to do at home to address the cause of the problem;
• Mobilize the muscles and soft tissues in the abdomen and pelvic floor.

Finally, if physiotherapy treatments are not sufficient, your physiotherapist will refer you to your doctor to evaluate other options.

When should you see a physiotherapist for fecal incontinence?

You should consult a physiotherapist if you have one or more of the symptoms described above or if your doctor has ruled out any other causes that may be responsible for your symptoms.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

What to do at home...

• Ensure you have a balanced diet and stay well hydrated;
• Engage in regular physical activity;
• Review your posture when sitting on the toilet.
  
  • When sitting on the toilet, place your feet on a stool so that your knees are slightly higher than your hips and lean slightly forward.

To learn more...

• Canadian Food Guide : https://guide-alimentaire.canada.ca/fr/
• Physical Activity Guide: https://www.canada.ca/fr/sante-publique/services/publications/vie-saine/conseils-activite-physique-adultes-18-64-ans.html