Photograph of a WC sign

Managing bowel incontinence

An involuntary leakage from the bowel may be something that happens once, only very occasionally, or more frequently. Whatever the frequency, it can lead to uncertainty and worry.

Like anyone else, you might get diarrhoea through infections, having an upset stomach from eating bad food, from antibiotics or medications.

But bowel incontinence in MS is often linked to constipation – stools become impacted in the bowel and there is leakage around them. There are other possible causes too.

Continence advisers are there to help.

You can self-refer to many NHS Continence Advisory Services, though in some cases you may need a referral from your GP. For details of your nearest service, contact the Bladder and Bowel Community.

The first step to getting help

An assessment is generally the first step to managing bowel incontinence.

A thorough assessment will help a health professional to work out if the problem is likely to be MS or other factors, to assess the extent of any nerve or muscle damage and to recommend the best treatment for you.

They have to ask you a lot of questions to see how they can help you. It may seem embarrassing or intrusive but it is best to answer fully. They will ask you general questions about past operations, childbirth (if relevant), and your diet and fluid intake. 

They might also ask you to keep a diary showing when your bowels open in the toilet, when you have a bowel accident or, if you wear a pad, when you need to change it. 

Medical staff will examine the anal sphincter muscles, but they can only really obtain an accurate evaluation of squeeze pressures by using an anorectal manometry test, where a small tube or balloon measures pressures in the anus. There are other tests to find structural problems, like tears in sphincter muscles. Endosonography uses ultrasound to scan the sphincter muscles. Defaecography uses x-rays to help medical staff assess the workings of the rectum and sphincter.

Tips for managing bowel incontinence

  • A balanced diet
  • A regular and comfortable routine
  • Medications
  • Controlling leakage and diarrhoea
  • Surgery

Managing day to day

  • Skin care
  • Odour control
  • Products to help
  • Planning

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