$Unique_ID{BRK00178}
$Pretitle{Digestive System}
$Title{What Can You Do About Bowel Incontinence?}
$Subject{incontinence bowel elderly treatments}
$Volume{I-13}
$Log{
The Colon*0001601.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


What Can You Do About Bowel Incontinence?


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QUESTION:  My mother, who is eighty, lives with us, and lately I've noticed
her bed linens and undergarments seem to be stained with bowel movements.  She
wouldn't talk to me about it, so what can I do?

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ANSWER:  I'm happy to answer your question, for it is frequently asked, not
only by family but also by those who suffer in silence from this distressful
situation.
     Bowel incontinence is a common problem with elderly patients--sometimes
it is a problem for which nothing is done because the patient refuses to
discuss it.  Basic human pride and dignity are at stake.  It signals for the
patient a return to infancy and the lack of ability to care for themselves.
Nursing homes loom on the horizon with all the lack of respect and
independence that they entail.
     It is not an unsurmountable problem, yes there are things that can be
done.  First, take your mother to her doctor and talk about the subject.  A
patient of mine--a spirited eighty-five year old woman, who lived with her
granddaughter, was having the same problem.  It took her three visits to open
up to me about it, and together we did something about it.  Mary and I first
discussed the commonality of the problem for many seniors and some of the
underlying reasons.  Probable causes are fecal impaction, underlying disease,
or neurogenic disorders.  Impaction is the most common problem; it simply
means a stool is stuck in the rectum and the incontinence takes the form of
the soft seeps that flow around the hard mass--very easily diagnosed through
rectal examination.  Some underlying disease may be the culprits:
diverticulitis, colitis, diabetes, and damage to the rectal muscles.  There
are times when the sphincter muscle, which controls the closing of the anus,
has been damaged by previous surgery or injury.  Neurogenic disorders
(disorders of the nervous regulatory system) can be either local or part of a
general condition.  There can be local degeneration of the bowel and rectal
muscles sometimes due to chronic use of laxatives or other drugs.  Mental
impairment can also be a cause.  Sometimes older folk forget what rectal
fullness feels like, especially stroke or dementia victims.  So your mother's
doctor will use his diagnostic tools and all the information necessary to
discover the root cause of her problem.  He will ask about physical status,
bowel history, nutrition, and the family unit.  He will look for degeneration
of the rectal muscles, whether she can reach the toilet, and what her diet
consists of.  Most importantly an optimistic attitude that something can be
done will be imparted to your mom.  Treatment of impaction and neurogenic
disorders begins with a regular bowel program, which must be consistent and
attainable.  He will encourage a high-fiber diet, plenty of fluids, and
planning for a time of day for a bowel movement.  Suppositories might be
suggested, initially once a day and eventually every other day.  If success is
not achieved, he'll suggest one of the many products on the market for both
bowel and urinary incontinence--pads that attach to undergarments, underpants
with pads attached, and finally disposable diapers.  Many cleansers are
available to wash the area and stop odors, and creams are available to soothe.
     Shakespeare told us about the seven ages of man, and though the last age
is very much like the first, infancy, geriatric caregivers can add a touch of
dignity, pride, and humor when caring for those who have indeed made it.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
