Diet And Medication - Treating Fecal Incontinence: Bladder Conditions

Content provided by the Faculty of the Harvard Medical School

Diet and medication

The good news is that your diet can have a major impact on your bowel function, changing the consistency of the stool and the predictability of your bowel movements. That means there are potentially beneficial changes that you can make, such as increasing the fiber content of your diet or eliminating foods that irritate your system. Depending on your symptoms, your doctor may suggest diet changes to improve bowel control or make your condition easier to manage.

Virtually everyone can derive some benefit from dietary advice. For example, people with sphincter problems can gain better control by taking steps to eliminate diarrhea. Symptoms of irritable bowel syndrome can be helped by identifying and eliminating specific irritating foods.

Controlling diarrhea

Diarrhea is the most common aggravating factor in fecal incontinence. If you tend to have loose stools, you may be able to make them firmer and easier to control by adding fiber to your diet or by taking a bulking agent or fiber supplement such as Citrucel or Konsyl. Because high-fiber diets are often recommended for people with constipation, it may seem counterintuitive to add fiber if you already have diarrhea. But dietary fiber can absorb up to 30 times its weight in water, thereby producing formed but soft stools. Good sources of dietary fiber are bran cereals, uncooked fruits and vegetables, whole-grain breads and pasta, and brown rice. This will "normalize" your bowels.

Specific foods trigger diarrhea in some people. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has identified a number of foods to try eliminating from your diet to see if your symptoms improve. According to the NIDDK, potential sources of trouble may include caffeine, cured or smoked meats, spicy foods, alcohol, dairy products, fruits, fatty and greasy foods, and sweeteners (such as sorbitol, xylitol, mannitol, and fructose) that are found in many diet drinks, fruit drinks, sugarless gum, and candies.

Your physician may also advise a change in the medications you take for other conditions, in case they are contributing to diarrhea and incontinence problems. As an example, the antidiabetic drug metformin (Glucophage) may result in chronic diarrhea that begins long after starting the drug. Orlistat (Xenical), a medication used to treat obesity, decreases the absorption of fat from the digestive tract. Side effects include several distressing bowel symptoms, including oily seepage from the rectum, fecal urgency, and fecal incontinence (in less than 10% of users). Serious gastrointestinal side effects, including fecal incontinence, have resulted when people using orlistat consumed snack foods that contained the fat substitute Olestra.

If food seems to move through your digestive system rapidly, your doctor may suggest an antidiarrheal medicine such as loperamide (Imodium) or diphenoxylate and atropine (Lomotil) to solidify your stools and make them less frequent. Loperamide has the side benefit of increasing muscle tone in the internal anal sphincter, which may also help with incontinence. The tricyclic antidepressant amitriptyline also reduces the number of bowel movements and has been successfully used to improve fecal incontinence, although not in a controlled study.

Managing constipation

If your fecal incontinence is related to constipation, your health professional may suggest ways to train yourself to have regularly timed bowel movements. These may include increasing your fiber and fluid intake and using various stimuli (from a warm drink to an enema, depending on need) to encourage a bowel movement at set times.

Last updated:	September 05, 2008