Settling due to embarrassment? Options for better bowel control.
Sometimes, the reasons older people withdraw from their social lives are hard to see – it might be because of eyesight, hearing or mobility issues. But, according to the National Institute of Health, more than 18 million Americans suffer from fecal incontinence, and that may be one of the reasons that older adults choose to remain at home rather than risk an embarrassing accident.
But thankfully, there are more options available than just suffering in silence. Dr. Gregory FitzHarris, a colorectal surgeon in Hampton, Virginia with Sentara Surgery Specialists, sees a number of people in his practice who are finally ready to take action about their incontinence issues.
“Usually people come to see me and I try to look at causes, and we look at the medications they are taking that might be causing this, any relevant medical history, such as having their gallbladder out or frequent constipation,” FitzHarris said.
There are a number of simple steps to start with, such as looking at dietary changes, lifestyle changes, medication, physical therapy and biofeedback. But one of the challenges is that people are embarrassed and wait to talk to their primary care doctors, and FitzHarris often reminds his patients that over his career in medicine, he’s heard it all.
“If we aren’t talking about it, we aren’t solving it. I often see older women who have had these issues since they were 65 but now at age 70, they are finally coming to see me,” he said. “And unfortunately, in that time they’ve been avoiding social events – staying home instead of bridge club or attending church. But they don’t need to suffer in silence.”
If the problem persists, two innovative options are available: sacral nerve stimulation and Solesta® injections.
Solesta® gel injections are a quick procedure done in Dr. FitzHarris’ office. The gel bulks up the bowel wall, in order to help prevent leaks. The thicker wall may block some of the anal canal to compensate for the weaker muscles. This procedure can be repeated if needed.
For more persistent cases, sacral nerve stimulation may be an option. It is a small implant that uses an electrical current to stimulate the sacral nerve in the lower back that may improve the connection of nerves between the bowel and colon and the brain. To ensure it works for the individual, a test run for two weeks with a temporary device shows whether this may be a good option for the patient. If it does work, the device is implanted deep in the fat of the buttocks, where it isn’t able to be seen or felt by the patient. Adjustments can be made to the frequency and strength of the stimulation as needed for better bowel control.
The most important thing is to get the issue addressed. Dr. FitzHarris suggests that patients experiencing bowel incontinence begin the process of addressing the issue so they can return to their social lives with more confidence.
“I try to make people feel comfortable and let them know we’ll manage it together. Let’s see how we can fix this,” Dr. FitzHarris said.
Things to look for that might make you a candidate for either procedure:
- Increased trips to the bathroom
- Unexpected leaks
- Muscle or nerve damage
- Drastic changes in your bowel habits
Dr. FitzHarris graduated from the Duke University School of Medicine in 1990. He works in Hampton, VA and specializes in Colon & Rectal Surgery. Dr. FitzHarris is affiliated with Sentara CarePlex Hospital.