Patient Perspective: Ellen's Story

Patient Perspective - Ellen's Story of Living With Incontinence

After the birth of my 2nd child, I began experiencing urinary incontinence.  I started leaking a bit here and there, and it only got worse as I got older. I assumed it was just a part of aging and that there was nothing I could do. And while the episodes were embarrassing, I was able to control and hide them pretty well by wearing protection and always keeping a close eye on the toilet. 
 
However, when my youngest was 15 years old, I had my first real bowel accident, and life as I knew it officially changed.  I began having more and more episodes, and eventually didn’t even want to leave the house because I was so terrified of having an accident.  I stopped seeing friends. I ordered groceries and most things I needed online.  I refused to go on dates with my husband.  There is something that feels just a little bit worse about having a bowel accident vs. having a bladder accident – it’s messier, smellier, much more apparent, and just so humiliating that you never want others to know it is something you are going through.  
 
I lived like this for six years before finally realizing that I wasn’t controlling my ABL, it was controlling me.  I got up the nerve to speak with my doctor and was able to have a surgery that helped alleviate many of my issues. 
 
All of this could not have come soon enough – my first granddaughter was born a year ago and to think that I may have missed out on that moment or all the wonderful ones that have followed makes me cringe. My only regret is that I didn’t do something about it sooner.
 
Ellen T., Atlanta, GA

What I've Learned About IBS And How To Treat It.

IBS, Bowel Health, And How To Treat It

IBS, Bowel Health, And How To Treat It

I was fairly young when I first started having bowel trouble. A consistently nervous young woman, I was constantly in a state of worry – about school, boys, and friendships – pretty much the normal run of the mill high school concerns. My mother always said I had “nervous bowels”, and my family became accustomed to stopping frequently to use the restroom on trips, and always asking me if I had to go before leaving the house.  The pain I felt sometimes with bloating or cramping was attributed to my nerves.  And while my family was fairly sympathetic to my condition, I experienced a lot of eye-rolling growing up when my symptoms would strike (“We have to stop for Annette again?” my brother would say. “She just went!”) It was a normal occurrence that lasted into my college years, and then later as I started a family.  And while it was inconvenient and could definitely be painful at times – it wasn’t until after the birth of my first child that I thought about it as a “condition” that could actually be treated. 

IBS, or irritable bowel syndrome, is when you have an overly sensitive colon or large intestine.  This may result in the contents of your bowel moving too quickly, resulting in diarrhea, or too slowly, resulting in constipation. (Both of which I have experienced, although my symptoms tend to lie more in the former camp, causing me to constantly race to the bathroom for fear of an accident).  Symptoms also can include cramping or abdominal pain, bloating, gas, or mucus in the stool. The condition is more common than you may think. As many as 1 in 5 American adults have IBS, the majority of them being women. And, this is not an old persons disease either – IBS strikes young, commonly in ages younger than 45.

I was finally diagnosed at age 28 – a whopping 13 years after I started experiencing symptoms, and I wish I had thought to seek help earlier.  My doctor told me that there are many things that can contribute to IBS. Things like hormones, certain types of food, and stress (I guess my mother was right) may all impact IBS symptoms.  Since the cause is of IBS is not known, treatments usually focus on relieving symptoms so that you can live as normally as possible. 

Below is a list of treatments my doctor discussed with me.

Behavioral Changes: 

Diet.  Many foods can trigger IBS. And, while they might not be the same for everyone, there are some common triggers that have been identified:

  • Alcohol

  • Caffeine (including coffee, chocolate)

  • Dairy products

  • Sugar-free sweeteners

  • High-gas foods, such as beans, cabbage, cauliflower, broccoli, raw fruits or carbonated beverages)

  • Fatty foods

  • FODMAPs (types of carbohydrates that are found in certain grans, vegetables fruits and dairy products)

  • Gluten

One of the first things I did when starting treatment was to keep a bowel diary, which tracked the foods I ate and how they effected me. This was a huge help in learning my food triggers.  I also learned to eat more frequent, smaller meals, which helped ease my symptoms. (Although those who experience more constipation may see improvement by eating larger amounts of high-fiber foods.)

Stress Management. This was a huge one for me.  It turns out, your brain controls your bowels, so if you’re a hand wringer like me, it may end up making you run to the bathroom more often than you’d like.  Learning ways to control stress was a game changer and I saw a huge improvement with these steps:

  • Meditation – Just taking the time to quite your mind can do wonders in helping you manage stress on a regular basis.

  • Physical Exercise – Regular exercise is a great de-stressor and, if you have constipation, can help keep things moving in that department too. I walk regularly and practice yoga 3 times per week to keep my stress at bay.

  • Deep Breathing Exercises – This is a great trick to practice if you feel yourself starting to get worked up. Practice counting to 10, while breathing in and out slowly until you start feeling relaxed.

  • Counseling – Sometimes you need someone to talk to help you work through your emotions. You may find comfort in talking with a friend or family member, or even a professional counselor, who can help you learn how to deal better with stress.

  • Massage – This one likely doesn’t need much explanation - who doesn’t love a good massage?

Drink Plenty Of Water. Drinking enough water just helps your body function better. And for people with IBS, it will ensure that everything moves more smoothly and minimize pain. This is especially true with those who suffer from constipation. 

Medications 

There are several different medications used to treat symptoms of IBS. Whether you suffer from constipation, or diarrhea, OTCs and prescriptions are available. Antibiotics are also sometimes prescribed for those patients whose symptoms are caused by an overgrowth of bacteria in the intestines. And if you suffer from anxiety or depression, like me, some antidepressants and anti-anxiety agents can actually improve your IBS symptoms too. Talk with your doctor about your symptoms and work with him or her to find a solution that’s best for you.

Other treatment options 

Acupuncture. Despite a lack of data on acupuncture and IBS, many patients turn to this method of treatment for pain and bloating. Acupuncture, which is usually performed by a licensed acupuncturist, targets specific points in the body to help channel energy flow properly.

Probiotics.  As research continues to emerge around the importance of gut bacteria and your overall health, probiotics may become a more common treatment option.  Consuming them can increase the “good” bacteria that live in your intestines and may help ease your symptoms. 

Hypnosis.  Hypnotherapy has been shown to improve symptoms by helping the patient to relax. Patients practicing hypnotherapy have reported improved quality of life, reduced abdominal pain and constipation, and reduced bloating. However, most of the time hypnotherapy is dependent upon a therapist, and is usually not covered by insurance plans, making it a costly form of therapy.

I’m 37 now and have had my IBS pretty much under control for the last several years. Looking back, I can’t believe I lived with it as “normal” for so long. If you suffer from this condition, there is simply no reason to not get it treated. 

Need help finding a doctor?  Use the NAFC Specialist Locator.

About the Author:  Annette Jennings lives in Oklahoma with her husband, 2 children, 2 dogs, and 1 cat. She's happy to be speaking up about her condition and hopes it will inspire more people to do so. 

The Growing Array Of Options For Managing Fecal Incontinence

Treatment Options For Fecal Incontinence

It wasn’t long ago that those suffering with fecal incontinence had just a handful of options. They could try behavioral modifications (still largely used today), absorbent products to help manage the condition, bowel retraining, medications, or surgery. But in the last several years, companies have been coming out with more and more innovative products to manage ABL. 

We’ve rounded up some of the newest products and therapies to help you control ABL.

Fenix® Implant:

The Fenix® Implant, is a small, flexible band of connected metal beads with magnetic cores that is placed around the anal canal to treat accidental bowel leakage (ABL). The beads will separate temporarily to allow the controlled passage of stool. The magnetic force between the beads then brings the implant back to the closed position to prevent unexpected opening of the anal canal that may lead to ABL.

Renew® Insert:

The Renew® Insert is a new product designed to comfortably fit with your body to form a seal with the rectum, which blocks the anal passage and prevents leaks from occurring.  

Eclipse™:

Eclipse™, which is fitted first by a physician, is an inflatable balloon device that is inserted into the vagina. When inflated, the balloon puts pressure through the vaginal wall onto the rectal area, thereby reducing the number of FI episodes.

SECCA:

The SECCA procedure is an outpatient procedure that can be performed in your doctor’s office. It is best used when other more conservative therapies have failed. The non-surgical procedure works by delivering radiofrequency energy to the tissues of the anal canal, causing the tissues to shrink and tighten.  SECCA takes about 45 minutes to perform and patients are able to return home 1-2 hours after the procedure. Most patients begin to see an improvement in 4 to 6 weeks.

InterStim™ System: 

Sacral Neuromodulation, delivered through the InterStim™ System, works by targeting the communication problem between the brain and the sacral nerves, which control the muscles related to bowel function.  This Bowel Control Therapy targets the symptoms of bowel incontinence by modulating the sacral nerves with mild electrical pulses. Sacral Neuromodulation typically only takes about 20 minutes in a doctor’s office.

Talk with your doctor to see if one of these products may work for you.  If you need help finding a physician, check out the NAFC Specialist Locator.

4 Common Myths Of Accidental Bowel Leakage

4 Common Myths Of Accidental Bowel Leakage

Accidental Bowel Leakage (ABL) is something no one likes to talk about. Even more so than urinary incontinence, fecal incontinence carries a stigma that is hard to shake. And yet, tens of millions Americans struggle with it on a regular basis.

Today, we’re dispelling 4 common myths associated with accidental bowel leakage:

MYTH:  ABL only happens when you have watery or loose stools.

FACT:  While things like diarrhea can create a strong sense of urgency and may indeed lead to leakage, other factors may also be at play.  Being constipated can be a cause of ABL too - when large hard stools get stuck in the rectum, watery stools can leak out around them.  Regular bouts of constipation can also stretch and weaken the rectum, making it harder for you to hold stools long enough to make it to the restroom. To that end, any damage to the muscles or nerves around the anus can create an ABL issue.  Things like childbirth, diabetes, stroke, hemorrhoid surgery, multiple sclerosis, or spinal cord injury all have the potential to cause ABL.

MYTH:  ABL only happens to older people

FACT:  While age does play a factor with ABL, leaky stools can happen to anyone who has had muscle or nerve damage to the anus, and can occur in people as young as 40.  ABL is more common in our older population though, due to decreased muscle and tissue elasticity, which makes it harder to hold a stool.

MYTH: Diet doesn’t affect ABL

FACT:  Diet can play a huge role in how and if you experience ABL. Everyone’s triggers are different - spicy food, fried and fatty foods, and food and drink with caffeine can cause problems for many. Additionally, eating larger meals can sometimes have a negative effect.  Try using a bowel diary to keep track of your food intake and your bowel problems. This may help you to see a trend in your eating habits that are leading to ABL.

MYTH:  There is nothing I can do to treat ABL

FACT:  ABL can and should be treated.  Watching what you eat, getting proper exercise (including pelvic floor exercises!), making certain behavior modifications, taking medication to address the issue are just a few of the things that can be done to combat ABL.  Surgery to correct the problem may also be an option for you.  The most important thing to remember is that you have options, and you owe it to yourself to seek them out by talking with your doctor.

Learn more about Accidental Bowel Leakage and available treatment options in our Conditions section.