For many IBS patients, the fear of having a bathroom “accident”, that is, experiencing fecal soiling or incontinence, is very real. Perhaps you have had one or more episodes in which you soiled yourself or you have had numerous “close calls” that keep you on guard. Fecal incontinence is not as uncommon as you may think; it affects approximately 6% to 15% of the population. Fecal incontinence is more likely to be experienced by women, and the risk of fecal incontinence rises with age. It is important to keep in mind that most of the cases of fecal incontinence are caused by infection or a diagnosable nerve or muscle disorder; a person with a first episode of fecal incontinence should seek medical attention for appropriate diagnosis and treatment.
There are times when a person who has been diagnosed with IBS may experience fecal soiling. A severe diarrhea episode can result in the passage of watery, loose stool that the muscles of the rectum are not able to contain. Constipation can also cause soiling, due to loose stool leaking around the hard impacted stool. Addressing the underlying diarrhea or constipation problem can minimize the risk of such soiling.
In my experience, the concern about soiling is very common for IBS patients, even in individuals who have never had a problem. This concern is certainly understandable as fecal soiling is, at best messy, and, at worst, extremely socially embarrassing. The problem is that as with many IBS triggers, the anxiety about soiling can increase intestinal contractions, thus increasing the odds of experiencing incontinence. Luckily, there are things you can do to help you and your body to remain calm until you are safely ensconced on a toilet.
Have a Little Faith
Patients often justify their concern about soiling, because they often get to the toilet just in the “the nick of time." These experiences do not necessarily mean that you would have had an accident. More likely, your rectum has done what it has been trained to do since you were little: hold on to the stool until you are sitting on the toilet. At that point, it lets go. So remind yourself to have faith that your rectal muscles will most likely do their job and keep things contained for you.
Use Active Calming Techniques
While you are making your way to a toilet, it is important to take steps to actively turn off your body’s stress response. Use deep breathing and calming self-talk to quiet your body rather than escalate the sense of urgency.
Hope for the Best, Plan for the Worst
One of the best ways to reduce anxiety is to have a plan in place to cover all contingencies. Before venturing out, make sure that you know where you will be able to access a restroom should the need arise. Tell any traveling companions about your unique health needs, so they can help to facilitate a quick pit stop.
If you have had a problem with soiling in the past and think there may be a delay in your ability to get to a restroom, pack or wear an adult sanitary product, and if necessary, bring along a change of clothes. Knowing that you are prepared for an unexpected episode will go a long way toward reducing the panic that can contribute to the sense of urgency.
Landefeld, C., et.al. National Institutes of Health State-of-the-Science Conference Statement: Prevention of Fecal and Urinary Incontinence in Adults Annals of Internal Medicine 2008 148:449-458.
DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.