For obvious reasons, the inability to control the passage of feces or intestinal gas can be a nightmare, creating the potential for embarrassing moments in public and private. Normally, a pair of sphincter muscles manages the timely and appropriate movement of stool through the rectum and out of the body. Damage to nerves regulating these sphincter muscles due to diabetic neuropathy or diminished muscle tone that may come with old age can lead to a loss of sensation and control, resulting in soiled undergarments and quick exits from social settings.

Treatments for this embarrassing problem range from simple lifestyle changes to surgery.

Diet and Medication

When bowel incontinence produces loose, watery stools, treating diarrhea is an essential first step. Patients are advised to consume more dietary fiber and take one or more of the medications described above in order to produce bulkier stools, which are more easily controlled.

A fiber-rich diet is one remedy for bowel incontinence.
A fiber-rich diet is one remedy for bowel incontinence.

Biofeedback

Biofeedback is any form of training that provides information about bodily functions with the goal of helping people gain conscious control over them. One common method for treating bowel incontinence is to insert a balloonlike device in the patient's rectum. Inflating the balloon helps the patient relearn how it feels to pass a stool. The patient then practices contracting rectal muscles in order to control the stool's passage. Some biofeedback proponents claim 70 percent of patients with bowel incontinence who undergo the training have improved symptoms, though in some studies actual success rates have been less impressive.

Surgery

In cases of severe bowel incontinence that doesn't respond to other therapies, surgery may be the next best hope. Surgeons have several options for restoring healthy bowel function. In patients suffering from nerve damage, muscles may be harvested from elsewhere in the body (such as the thigh) and transplanted to strengthen contractions in the rectum. Artificial bowel sphincters are another option; they ensure that the feces cannot pass until the patient manually deflates a special "cuff." Fecal diversion is a final alternative. Also called a colostomy, this approach empties stool from the colon through a portal surgically implanted in the abdomen and into a special collection bag.

Sacral Nerve Stimulation

This experimental treatment is similar to electrical devices implanted in the gut to improve stomach muscle contractions. Studies in Europe have found that patients who have these small devices implanted in the lower back have better bowel control. However, the treatment is not yet available in the United States.

For more information on diabetes and its effect on digestion, try the following links:

  • Find out why -- and how -- diabetes may lead to stomach problems at Diabetes and Digestive Problems.
  • Diabetic Neuropathy explains the relationship between blood glucose levels and the nervous system.
  • Symptoms of Diabetes covers the diverse signs of the disease, from increased thirst and hunger to sudden weight loss.
  • To learn more about diabetes in general, including diagnosis, causes, symptoms, and treatment, visit our main Diabetes page.
ABOUT THE AUTHOR:

Timothy Gower is a freelance writer and the author of several books. His work has appeared in many magazines and newspapers, including Prevention, Health, Reader's Digest, Better Homes and Gardens, Men's Health, Esquire, Fortune, The New York Times, and The Los Angeles Times.

ABOUT THE CONSULTANTS:

Dana Armstrong, R.D., C.D.E., received her degree in nutrition and dietetics from the University of California, Davis, and completed her dietetic internship at the University of Nebraska Medical Center in Omaha. She has developed educational programs that have benefited more than 5,000 patients with diabetes. She specializes in and speaks nationally on approaches to disease treatment, specifically diabetes.

Allen Bennett King, M.D., F.A.C.P., F.A.C.E., C.D.E. is the author of more than 50 papers in medical science and speaks nationally on new advances in diabetes. He is an associate clinical professor at the University of California Natividad Medical Center and cofounder and medical director of the Diabetes Care Center in Salinas, California.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.