Controlling your IBD

Treatment strategies

Depending on the cause of your incontinence, treatment may include dietary changes, medication, special exercises that help you to better control your bowels, and/or surgery. Increasing or changing your medication can also be helpful. Always discuss these options with your health care professional.

Non-surgical treatments

Antidiarrhoeal drugs such as loperamide work by altering the muscle activity of the intestines to slow the movement of bowel contents. Some also increase water re-uptake from the intestines. These should not be taken by people with active colitis.

Topical therapies (a cream or gel) like phenylephrine, which increase the tone in the anal sphincter, can be useful in managing incontinence.

Physical therapy such as sphincter exercise is a means of treating faecal incontinence which aims to help you strengthen your anal sphincter muscles and so help to achieve better control.

Biofeedback is a means of bringing symptoms under control. Biofeedback techniques can be taught to help control and strengthen anal muscles. These exercises, called Kegel exercises, are evaluated by a computer which provides feedback such as whether you are performing the exercises correctly, and whether your muscles are becoming strengthened.

Surgery to treat faecal incontinence

Surgery is an option with severe disease if medication, dietary change and biofeedback do not help, or if there is injury to the anal sphincter, anal canal, or pelvic floor. Surgery can repair injury to the sphincter mechanism, or can help constrict the sphincter using either your own body tissue or a surgical device. As an alternative, minor surgery may be possible for rectal prolapse (where the rectum protrudes through the anus) which means less postoperative pain, less medication, and more rapid healing when compared with traditional open surgical techniques

With very severe faecal incontinence, where other treatments do not help, a colostomy may be performed. This is a surgical procedure that brings the end of the large intestine through the abdominal wall so that stools moving through the intestine drain into a bag, which may be temporarily or permanently attached to the abdomen. A colostomy will ultimately resolve your incontinence problem, and so vastly improve your quality of life.

Surgery is usually only needed in cases of severe IBD.