By Keith Meslin, MD, Virtua Colorectal Surgeon
Michelle Peshick, PT, Virtua Physical Therapist

If you’re a woman struggling with bowel incontinence, you’ve likely experienced loss of control at the worst possible moment. Our patients have reported that they feel embarrassed, humiliated and isolated—even from spouses.

This is the most important thing to know: You DO NOT have to endure this very treatable issue.

Virtua experts explain your treatment options.

Dr. Meslin explains medical treatment options for bowel incontinence

A major cause of bowel incontinence in women is damage to the pelvic floor during vaginal childbirth. However, a woman’s risk for developing bowel incontinence increases as she ages, generally peaking sometime between ages 50 to 70. In addition, women are more than twice as likely as men to experience this issue.

While an accident might cause embarrassment, there’s no need to be embarrassed about talking to your doctor. Your doctor understands how sensitive this issue is and will listen to your concerns and lay out all the available treatment options.

I usually recommend one or more of the following treatments that offer patients successful relief.

Diet 
Usually women with bowel leakage find that their stools are too loose. Eating plenty of fiber, mostly from whole grains, fresh fruits and vegetables, helps produce firmer stools.

Medications
If frequency and urgency are major concerns, I recommend over-the-counter and/or prescription medications that can help slow down your digestive system.

Sacral Nerve Stimulator
Interstim is an implantable and customizable device that stimulates the sacral nerves (the nerves that deliver impulses from the brain to help control bladder and bowel function). This is a good option for women who have sensation issues causing incontinence.

Physical Therapy
For women who are especially motivated to work hard for their recovery, physical therapy can yield impressive results in bowel incontinence treatment. 

(Note: for some women, surgery may be the only option to repair underlying muscle or nerve damage.)

Michelle Peshick explains physical therapy treatment options

As a physical therapist who specializes in female pelvic medicine, I work with many women who have trouble with bowel incontinence. That’s because the pelvic floor muscles play a very important role in proper bowel function. If these muscles are injured or weakened during childbirth, it can lead to fecal leakage and loss of bowel control.

During physical therapy, a woman learns, with expert guidance, the essential exercises that strengthen the pelvic floor. Physical therapists also employ biofeedback technology as a treatment aide for bowel incontinence. Biofeedback uses an internal sensor to measure the effectiveness of certain exercises and monitor treatment progress over time. Every woman is different, but many can expect a considerable improvement in symptoms after completing a course of physical therapy.

Women often worry about their first visit to a physical therapist for bowel incontinence treatment. We’re very attuned to the sensitivity of this issue, so we start slowly with a one-on-one information and education session. During therapy, biofeedback procedures take place in a private room. We tailor treatment plans to fit each woman individually, and we take special care to make the entire process as discreet and comfortable as possible.

You don’t have to suffer in silence about bowel incontinence—talk to your doctor about whether a referral to physical therapy is a smart next step.