Living with faecal incontinence

For many people, bowel or faecal incontinence (FI) can cause embarrassment, fear and feelings of isolation. However, with FI affecting up to 20% of men and up to 12.9% of women, according to the Australian Institute of Health and Welfare, there are many others with this condition.

Faecal incontinence refers to the loss of voluntary bowel control, which can vary in severity from losing a small amount of stool to losing complete control of bowel movements.

It can be challenging to manage your life around FI, but with some practical advice and forward planning, it’s possible to live your life to the fullest. We understand that you’ll probably be feeling anxious or distressed if you’ve just been diagnosed with FI. Remember, there’s help available and FI can be successfully treated.

The Continence Foundation of Australia states that one of the first steps after diagnosis is to consult a continence professional who can help you consider various treatment options and devise a customised strategy suited to your needs and lifestyle.

You can also contact the National Continence Helpline on 1800 33 00 66 for a confidential discussion with a continence nurse advisor. They’ll be able to give you advice on everyday living as well as details of product suppliers and continence professionals in your area.

Don’t be discouraged. It may take some some trial and error to come up with a workable plan for everyday routines, coping with the occasional “accident”, and dealing with work and social activities. Persevere in the knowledge that there’s ongoing development of new incontinence treatments and products. This means that there are more options to handle this condition than ever before.

Practical strategies
When creating a life management plan for FI, start off by considering practical strategies for different situations or scenarios such as:

• Home
• Work
• Sport and exercise
• Social outings
• Travel
• Relationships, sex and intimacy

The way you deal with each of these scenarios may differ, but these simple steps will lead you in the right direction to minimise bowel leakage:

• Find out or estimate the duration of the activity or event.
• Prepare for possible accidents by making sure you carry a bag with a spare set of clothes/underwear as well as cleanup supplies (e.g. disposable wet wipes and odour-neutralising products).
• First experiment and try out new strategies at home before going out in public to avoid any awkward social situations.
• Check where public toilets are located when going shopping or meeting friends for coffee at a shopping mall.
• Monitor your food intake by making a list of what you eat for a week. If you can identify problem foods that seem to be linked with bouts of FI, stop eating them and see if things improve.
• Foods that can cause gas or diarrhoea and worsen FI include spicy, fatty and greasy foods, alcohol, beverages that contain caffeine or are carbonated, smoked/cured meat, dairy products (if you're lactose intolerant) as well as products that contain artificial sweeteners (e.g. diet foods, sugar-free gum or sweets).
• Increase your water intake – try to drink at least eight glasses of water a day.
• You may also want to take anti-diarrhoeal medication before dining out in social situations, as bowel movements or passing gas are most likely to occur shortly after eating.
• Eat smaller meals more often, as this can reduce bowel movement frequency.
• Gradually increase the amount of fibre in your diet to ensure you’re getting 25 to 30g every day. Fibre (found mostly in vegetables, fruits and whole-grain cereals and breads) increases stool bulk and often also improves stool consistency.
• Make a habit of using the toilet before leaving the house.
• If you’re anxious about odour, use faecal deodorant pills to reduce the smell of gas and stool.

Skin care
Avoid further distress from FI by keeping the sensitive skin around your anus as clean and dry as possible. This not only helps to eliminate any possible FI-associated odours, but also relieves anal discomfort such as itching and pain.

Here are some useful tips:

• Wash regularly – gently wash the anal area with lukewarm water each time after a bowel movement.
• Avoid soap as it is drying and irritates the skin. Instead, use no-rinse skin cleansers or pre-moistened alcohol-free wipes/towelettes.
• Wipe with a pre-moistened alcohol-free towelette instead of dry toilet paper to avoid skin irritation.
• Keep the area dry – allow the anal area to air dry after washing. If there isn’t enough time to do this, gently pat the area dry with a lint-free cloth or clean washcloth.
• Change soiled underwear as soon as possible.
• Use a moisture-barrier cream containing dimethicone to prevent irritated skin coming into direct contact with faeces. Always ensure the area is clean and dry before applying barrier cream.
• You can also use non-medicated talcum powder or cornstarch to ease anal discomfort. Remember to clean and dry the area before applying it.
• If medical treatments fail to completely eliminate FI, use absorbent pads, disposable underwear or adult diapers to help manage the problem. Choose ones with an absorbent wicking layer on top to keep moisture away from the skin.
• Avoid tight clothes or underwear made from fabric that restricts airflow. It’s best to wear cotton underwear and loose, breathable clothes that allow air to circulate and keep skin dry.

1., Living with Bowel Control Problems
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