Soiling

Adult Faecal Incontinence

Soiling in adults usually results from an overwhelming urgency to open the bowels. This cannot be delayed and causes severe embarrassment and distress when soiling occurs. The effect on individuals of this soiling is to limit their activities so as to remain close to home.

CAUSES

Diet
During the course of our lives foods which previously were well tolerated, may become irritating to the gut, resulting in urgent and strong contractions which cannot be controlled by the anal sphincter.

Constipation
Blockages caused by constipation may occur high up in the bowel. Around the impacted faeces, liquid stools (similar to diarrhoea) flow. This is called “Overflow”. This liquid cannot be controlled because the anal sphincter is designed for retaining solids, not liquids.

Exercise
Often walking or running can stimulate the bowel into action. Under normal circumstances this is not a problem, because if no toilet is available, it is easy enough to defer opening the bowels. However, if the bowel action becomes very strong and urgent, and no toilet is available soiling accidents occur.

TREATMENT

• History – Careful attention to the origin of the problems, and investigation of current diet and fluid intake.
• Pelvic floor strengthening exercises – Individual, personalized prescription of exercises.

Soiling in Children

Soiling occurs when there is uncontrolled emptying of the bowel. This can occur at any time and causes severe embarrassment and results in social problems for school aged children and acute anxiety for adults. This problem can be experienced by adults and children of any age. It can be sorted with a program specifically addressing individual problems. It can be fixed.

CAUSES

Diarrhoea
The stools may be too loose or liquid as in the case of severe Diarrhoea. The anal sphincter (opening to the bowel) is designed to control the emptying of a solid mass at an appropriate time. It is never able to control liquid.

Constipation
Constipation is a major cause of soiling. It can cause a blockage anywhere in the bowel and liquid can overflow around this blockage. The sphincter cannot control this rush of liquid. It then appears there is a problem with diarrhoea, however, the primary cause is constipation.

Retained Stools
Fear of opening the bowels causes children to repeatedly hang on or defer doing a poo. This is usually associated with a previous tear of the anal sphincter and severe pain. Especially in children this can cause great anxiety and fear related to doing poos, and it can become a big problem at home and at school.

TREATMENT

• Teaching good bowel habits – no straining or pain.
• Pelvic floor training.
• Maintaining good consistency of stools – not too hard or too soft.