Medical Director
Senior Consultant, General & Colorectal Surgeon
MBBS (Singapore), MRCS (Edinburgh), MMed (Surgery), FRCS (Edinburgh)
Faecal (bowel) incontinence refers to the inability to properly control one's bowel movements, resulting in stool leaking unexpectedly from the rectum when you don’t want it to. It can occur at all ages but tends to occur in older age groups and women.
- Stool leaks out involuntarily when passing gas
- The urge to pass motion comes and you are not able to make it to the bathroom in time and soil yourself
- Stained underwear after a normal bowel movement
- Stools leak out during physical activity or daily life exertions
Why does Bowel Incontinence Occur?
- When the muscles in the rectum and anus are not functioning normally. A possible cause is frequent diarrhoea or constipation, which causes these muscles to weaken.
- When the rectum is unable to stretch properly due to not being as elastic as it should be, the rectum fills up with stool quickly and excess stool can leak out.
- When the anal sphincter muscles are not able to squeeze the anus shut and hold stool in. This could occur with old age (as the muscles weaken), past perianal procedures, difficult childbirth or previous trauma to the pelvis or anus region.
- When one's "rectal sensation" is not present, one will not know that one needs to go to the toilet. This is caused by nerve damage from cancers, previous surgeries, or neurological issues like a stroke or spinal tumour.
If bowel incontinence is disrupting your life, let us help you regain control.
Get in touch with our specialist for personalised treatment options today.
Bowel Incontinence Treatment
Importantly, conditions such as colorectal cancers especially low rectal cancers invading anal muscle sphincters or large polyps especially in the rectum which can also lead to mucus secretions, need to be excluded before treatment can be administered. Conditions that cause excessive diarrhoea will also need to be evaluated. A colonoscopy will usually be performed first to ensure that there are no underlying conditions prior to discussing further treatment.
Other investigations such as a Anal manometry, Endoluminal Ultrasound of the anus, Proctography or MRI may be required as well. Treatment depends on the cause and severity of the faecal incontinence, and can include dietary and lifestyle changes, bowel training, exercises to strengthen pelvic floor muscles, medications and surgery only if the above conservative measures do not work.
Lifestyle Changes
Simply wearing absorbent pads or adult diapers can help keep your underwear clean and make cleaning up after a bowel movement much easier.
Dietary Changes
The goals are to avoid foods that cause loose stool (e.g. caffeine, greasy or spicy foods) and to eat more foods that prevent constipation (e.g. bananas, staying hydrated).
Bowel Training
Developing a regular bowel movement pattern can improve bowel incontinence. The idea is to have bowel movements at specific times of the day until the body eventually gets used to the pattern, reducing instances of constipation and its associated bowel incontinence.
Pelvic Floor Exercise
Strengthening the pelvic floor muscles can help improve bowel control. These exercises involve squeezing and relaxing the pelvic floor muscles repeatedly; your doctor will best advise you on the frequency needed.
Biofeedback
Biofeedback therapy helps improve a person's awareness of sensations in the rectum. This helps patients improve the coordination of squeezing the sphincter muscle with the sensation of rectal filling.
Medications
Depending on the cause of bowel incontinence, you may be prescribed medications to control diarrhoea, bulk the stool, or any other disease contributing to the problem (e.g. inflammatory bowel disease).
Surgery may be an option when other conservative treatments do not suffice. It is estimated that around 40% of patients with bowel incontinence will require surgical treatments in order to effectively regain bowel control.
- Sphincteroplasty: The most common procedure for bowel incontinence, this method involves reconnecting the separated ends of an anal sphincter muscle that was previously torn (e.g. as a result of childbirth or injury).
- Rectal Prolapse Surgery: In patients whose bowel incontinence is a result of pelvic floor weakness that causes the rectum to "fall out" (prolapse), this procedure can lift the rectum and surgically secure it into its rightful place.
Our Colorectal Specialist
Dr Chew Min Hoe
Medical Director
Senior Consultant, General & Colorectal Surgeon
MBBS (Singapore), MRCS (Edinburgh), MMed (Surgery), FRCS (Edinburgh)
Dr Chew Min Hoe is a colorectal surgeon with more than 15 years of experience providing dedicated care for patients with bowel incontinence and other colorectal conditions. He offers personalised treatment plans, encompassing both conservative and surgical options.
For his contributions to the field, Dr Chew was awarded the Public Administration Medal (Bronze) in 2020. Beyond patient care, Dr Chew served as President of the Society of Colorectal Surgeons, Singapore, and founding head of the department of surgery, Sengkang General Hospital.
Our Motto
Caring Hearts, Educated Minds, Skilled Hands
Orchard
3 Mount Elizabeth #16-09, Mount Elizabeth Medical Centre,Singapore 228510
Tel:+65 6518 4688
Fax:+65 6235 0897
Mon-Fri:8:30am - 5:30pm
Sat / PH Eve:8:30am - 12:00 noon
Sun & Public Holiday: Closed
Farrer Park
1 Farrer Park Station Road Connexion,#08-07 Farrer Park Medical Centre,Singapore 217562
Tel:+65 6518 4868
Fax:+65 6443 6616
Mon-Fri:8:30am - 5:30pm
Sat / PH Eve:8:30am - 12:00 noon
Sun & Public Holiday: Closed
