Treatment and Management

The aims of treatment in faecal incontinence are to remove or improve both the underlying cause(s) and the contributory factors.

Treatment of diarrhoea

Underlying diarrhoea is treated with anti diarrhoeal medications such as loperamide and codeine phosphate. In inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease drugs are prescribed to modify the underlying disease process, thus relieving diarrhoea. Faecal impaction causing spurious diarrhoea is treated with enemas.

Improvement of bowel habit

Diarrhoea, constipation and faecal impaction can be improved by attention to dietary factors e.g. increased roughage, and adequate fluid intake. People are helped by going to the toilet on a routine basis, allowing adequate time for defaecation and having easy access to the toilet.

Incontinence aids

There are a wide variety of incontinence pads and waterproof pants that can be used by people with faecal incontinence. These may need to be used in conjunction with barrier creams and special cleaning products to protect the skin from rashes and infection.

Bowel retraining and incontinence programmes

Education and training of people and their carers in managing faecal incontinence is undertaken by specialist teams, which include incontinence nurses, physiotherapists, occupational therapists and dieticians.

Specialist investigation and surgery

Remediable causes such as rectal prolapse and severe haemorrhoids are treated with routine surgery. Specialist investigation including barium proctograms, electrophysiological techniques, ultrasound and MRI scans are used to assess and treat impaired ano-rectal function. Surgery may also be used to repair the anal sphincter or insert an artificial sphincter. Other techniques involve use of devices to stimulate the pelvic nerves that control defaecation.

Amended April 2008