It’s one of the worst feelings there is: the sense you’re going to lose control of the bowels.

And if accidental bowel leakage actually occurs, it can feel like the worst calamity.

It’s human nature for this to be one of the worst fears. Control of our bodily functions is integral to our sense of dignity as adults. Loss of control brings with it the potential for deep shame and can make us feel either childlike (like before we developed control) or as though we are “old and worn-out” (which we dread, no matter what our age). And if loss of bladder control can feel disastrous, loss of control of the bowels is that much worse.

Accidental bowel leakage is often known as faecal incontinence.

If you have this problem, then giving it this label probably makes it even worse. It conjures up the most extreme possible images. In actual fact, accidental bowel leakage is a spectrum from the “barely there” mark or stain on the underwear, to the “worst case scenario” of loss of a full bowel motion in a public place. It can occur with urge (you needed to go but couldn’t get there in time) or with physical exertion (such as squatting or sneezing). It can occur with no sensation whatsoever – you go to the toilet and notice a mark on your underwear, having no idea it occurred. It can be so slight that there is not even a sign on the underwear – but you feel that awful sense that something is coming out, and when you go to the toilet, there is something to wipe away. Accidental bowel leakage also covers the problem of passing wind without meaning to, or when trying not to. This commonly occurs when bending over, squatting, or moving from sitting to standing, but can also occur with coughing, sneezing or even laughing (which has a way of immediately wiping the smile off your face).

Overall, accidental bowel leakage can appear in a variety of ways, and can be socially devastating – even if it is simply the fear and dread that it is going to happen. It can affect your life in so many ways. One young man I saw was a mechanic in the army and had to keep leaving his work to go to the toilet. His problem had occurred after haemorrhoid surgery. Another young girl who had severe bowel urgency while in hospital with a stomach problem went on to develop a chronic pelvic pain syndrome because she was “hanging on so tight” for fear of leakage. I have seen several people with full loss of bowel control from the effects of radiation for cancer. It can even occur in association with irritable bowel syndrome. And postnatally, loss of bowel control is cruelly prevalent, especially after injury to the anal sphincter, as in a third-degree tear or episiotomy.

Despite its devastating impact, research from last year showed that more than two-thirds of women with accidental bowel leakage do not seek help for it. Considering that this is treatable and often curable, this seems to me to be the real tragedy.



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