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Fecal Incontinence: Medical Management and Treatment

Let's take a look at some medical interventions for fecal incontinence.

Conservative and first-line treatment

     Laxatives

     Other medical treatments

There are several, and many of them are familiar. A common medication, Imodium (loperamide), is used to treat loose stools. This is very effective and easy to administer, and so is a preferred treatment.

Other medical treatments include Kaopectate, which works by absorbing excess fluid in the stool, and cholestyramine, which binds cathartic bile acids in patients who have a history of cholecystectomy or ileocolonic resection. There is also some use of opioids which decrease intestinal motility and secretion, but there with this comes the risk of drug dependency (and constipation), so this option is not used very often. 

 

Summary

Incontinence is not a consequence of aging

It is treatable

Healthcare providers should bring up the topic with their patients

Bladder and bowel incontinence are common problems that often go unreported—and for that reason, untreated. Due to shame and embarrassment, many people are hesitant to discuss these issues with their healthcare providers. This incontinence can result in both physical and emotional problems that can significantly impact the patient’s quality of life. And while older adults often consider incontinence a consequence of aging (and one they must learn to live with), it is, in fact, one which their healthcare team can--and should--address to either maintain, regain or improve their patient’s quality of life.

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References:

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Dowling Castronovo A, Spiro EL. Urinary incontinence assessment in older adults: part II – established urinary incontinence. Try This ®. 2018. 11.2. Available at: https://hign.org/sites/default/files/2020-06/Try_This_General_Assessment_11_Part_2.pdf

Mayo Clinic Staff. Kegel exercises: a how-to guide for women. Available at: https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283

American Academy of Family Physicians. Bladder training for urinary incontinence. Available at: https://familydoctor.org/bladder-training-urinary-incontinence/

Wing et al. Effect of weight loss on urinary incontinence in overweight and obese women: results at 12 and 18 months. J Urol. 2010;184(3):1005-1010. Available at: https://pubmed.ncbi.nlm.nih.gov/20643425/

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Fecal Incontinence Severity Index. Available at: https://www.mdapp.co/fecal-incontinence-severity-index-fisi-calculator-234/